Stacey Lynn Glynn, MSW, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801092338 Issued in MI

Practice address

1115 Ball Ave NE
Building C
Grand Rapids, MI 49505

Phone

(616) 456-6571

Fax

(616) 451-0020

NPI assigned

May 3, 2011

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

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

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arbor Circle CorporationGroup PAC ID 2668362393, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Arbor Circle Corporation

  • Clinical Social Worker
  • Grand Rapids, MI
  • NPI 1174601512
  Medicare reassignment Care Compare group NPD
• Arbor Circle Corporation

  • Addiction (Substance Use Disorder) Counselor
  • Norton Shores, MI
  • NPI 1134614696
  NPD (past)
• Arbor Circle Corporation

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1740585330
  NPD (past)

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1154613669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 HAYES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49424",
            "telephone_number": "231-343-7657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 BALL AVE NE",
            "address_2": "BUILDING C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49505",
            "telephone_number": "616-456-6571",
            "fax_number": "616-451-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLYNN",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Dawn Glover, LLMSW
• Lisa Glover, CTRS
• Brooke Glowacki, BS
• Whitney Glowiak
• Meghan Glynn, ATC, LAT
• Jaclyn M Goble, PA
• Lindsay Marie Gockenbach, PT, DPT
• Evan Godfrey
• Joshua A Godfrey, LMSW
• Danielle Godwin, PA-C

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.