Individual provider Active NPI

Stacy Nicole Jones, MSW

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1144710773
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801102852 Issued in MI
Practice address
1701 Lake Lansing Rd Ste 120
Lansing, MI 48912-3798
Phone
(810) 494-7180
Fax
(810) 215-1334
NPI assigned
May 18, 2018
Last updated
Dec 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Clinical Social Worker 1041C0700X 6801102852 MI Primary

Addresses

Primary practice location

1701 Lake Lansing Rd Ste 120
Lansing, MI 48912-3798

Mailing address

1100 Torrey Rd Ste 100
Fenton, MI 48430-3327
Phone (810) 494-7180

Other practice location 1

1033 Healthcare Dr
Charlotte, MI 48813-1058
Phone (517) 543-2430 ext. 2667

Other names 1

  • Stacy Sharon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210302001771 MI Practitioner - Clinical Social Worker 8527474311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

1400 Abbot Rd
Suite 400
East Lansing, MI 48823-1900
Phone (517) 882-3732

7300 Dixie Hwy
Suite 1000
Clarkston, MI 48346-5105
Phone (248) 922-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102852MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Clinical CurrentSince Jul 1, 2022 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Jul 1, 2022 Accepting new patients

Locations

7300 Dixie Hwy
Ste 1000
Clarkston, MI 48346
Phone (248) 922-2230

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

1100 Torrey Rd
Ste 100
Fenton, MI 48430
Phone 8104947180106

1701 Lake Lansing Rd
Ste 120
Lansing, MI 48912
Phone 8104947180 ext. 106

4136 Legacy Pkwy
Lansing, MI 48911
Phone (517) 492-0517

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.stacyjones@150339.advancedmd-direct.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1144710773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 TORREY RD STE 100",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303327",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 LAKE LANSING RD STE 120",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123798",
            "telephone_number": "810-494-7180",
            "fax_number": "810-215-1334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1033 Healthcare Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "MI",
            "postal_code": "488131058",
            "country_code": "US",
            "telephone_number": "517-543-2430 x2667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "STACY",
        "middle_name": "NICOLE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801102852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "SHARON",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.