Stacy M Mandato, MSSA, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1801296-SUPV Issued in OH

Practice address

1302 W Main St Ste a
Louisville, OH 44641-1114

Phone

(330) 875-5544

Fax

(330) 875-8150

NPI assigned

Feb 3, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: stacy.mandato@chci.eclinicaldirectplus.com

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.

• Radiology Associates of Canton, Inc.

  • Diagnostic Radiology Physician
  • Canton, OH
  • NPI 1912982034
  NPD (past)

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1174829469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932909",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441932909",
            "telephone_number": "330-825-1152",
            "fax_number": "330-854-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 W MAIN ST STE A",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446411114",
            "telephone_number": "330-875-5544",
            "fax_number": "330-875-8150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8445 Munson Rd",
            "address_purpose": "LOCATION",
            "city": "Mentor",
            "state": "OH",
            "postal_code": "440602410",
            "country_code": "US",
            "telephone_number": "440-255-1700 x1457",
            "fax_number": "440-205-2417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDATO",
        "first_name": "STACY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MSSA, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-03",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "S1000364",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1801296-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2069738",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Stacy.Mandato@chci.eclinicaldirectplus.com",
            "affiliation": "Y",
            "affiliationName": "Community Health Care Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1302 W Main St Ste A",
            "city": "Louisville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446411114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Louisville Medical Center Physicians Inc.
• Louisville Pharmacy Inc
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• Lousiville Pharmacy Inc
• Jarvis Mack
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• April Marshall Woolf, PTA
• Tonia Martel
• Alexa Matsui, APRN CNP
• Jennifer L Mattern

• Clinical Social Worker in Louisville, OH
• Providers in Louisville, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.