Active NPI
Stephanie Stauffer, LISW-CP
- Clinical Social Worker
- Charleston, SC
National Provider Identifier
1194161109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 15863
- Practice address
- 21 Gamecock Ave Ste E
Charleston, SC 29407-3368 - Phone
- (843) 410-3933
- NPI assigned
- May 16, 2013
- Last updated
- Aug 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 15863 | SC | Primary |
Addresses
Primary practice location
21 Gamecock Ave Ste E
Charleston, SC 29407-3368
Mailing address
21 Gamecock Ave Ste E
Charleston, SC 29407-3368
Phone (434) 103-9338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100751163 | Medicaid | PA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15863 | SC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691452800000",
"number": "1194161109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 GAMECOCK AVE STE E",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294073368",
"telephone_number": "434-103-9338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 GAMECOCK AVE STE E",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294073368",
"telephone_number": "843-410-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAUFFER",
"first_name": "STEPHANIE",
"name_prefix": "Mrs.",
"credential": "LISW-CP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-16",
"last_updated": "2023-08-08",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "SC",
"license": "15863",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100751163",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.