Individual provider Active NPI

Stacey Marie Canfield, LICSW

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1154841799
Registry record updated Jun 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110555 Issued in MA
Practice address
411 Chandler St
Worcester, MA 01602-3339
Phone
(508) 799-0688
NPI assigned
Jun 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 110555 MA Primary

Addresses

Primary practice location

411 Chandler St
Worcester, MA 01602-3339

Mailing address

411 Chandler St
Worcester, MA 01602-3339
Phone (508) 799-0688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110555MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1498348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498348800000",
    "number": "1154841799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CHANDLER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016023339",
            "telephone_number": "508-799-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CHANDLER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016023339",
            "telephone_number": "508-799-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANFIELD",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-25",
        "last_updated": "2017-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2017; 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.