Individual provider Active NPI

Stacie Larae Weires

  • Clinical Social Worker
  • West Des Moines, IA
National Provider Identifier
1215018593
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
05746 Issued in IA
Practice address
950 Office Park Rd
West Des Moines, IA 50265-2549
Phone
(515) 279-2834
Fax
(515) 279-4168
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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 05746 IA Primary

Addresses

Primary practice location

950 Office Park Rd
West Des Moines, IA 50265-2549

Mailing address

1708 2ND Ave SW
Altoona, IA 50009-5810
Phone (515) 238-1947

Other identifiers 1

IdentifierTypeStateIssuer
492664000MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20120606000656 IA Practitioner - Clinical Social Worker 6901060797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

950 Office Park Rd
Suite 321
West Des Moines, IA 50265-2548
Phone (515) 500-2158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stacie Weires Counseling LLC Clinical CurrentSince Mar 27, 2021 Accepting new patients
Catholic Charities Past Accepting new patients
Catholic Council for Social Concern Clinical PastSince Feb 13, 2012 Accepting new patients

Locations

950 Office Park Rd
Ste 321
West Des Moines, IA 50265
Phone (515) 279-2834

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1215018593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 2ND AVE SW",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500095810",
            "telephone_number": "515-238-1947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 OFFICE PARK RD",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652549",
            "telephone_number": "515-279-2834",
            "fax_number": "515-279-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIRES",
        "first_name": "STACIE",
        "middle_name": "LARAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "05746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "492664000",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.