Stacey Lynn Monroe

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.020397 Issued in IL

Practice address

2855 Telegraph Ave Ste 515
Berkeley, CA 94705-1151

Phone

(309) 643-9926

NPI assigned

Jan 14, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stacey Monroe Kaiser Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1124592050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 BEVERLY DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858191",
            "telephone_number": "309-643-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE STE 515",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051151",
            "telephone_number": "309-643-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONROE",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-14",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "KAISER",
            "middle_name": "MONROE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Lee Moncayo
• Lina Patricia Monclova, BIRTH & PP DOULA
• Marisa Bianca Moncrieffe, RN
• James Mone
• Joan Arline Monheit, LCSW
• Louise Monsour, LMFT
• Stephanie Montague
• Filippo Montalbano, MS
• Jessica Montellano
• Edlin Montero

• Clinical Social Worker in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.