Stacy June Wayland, LICSW

Individual provider Active NPI Clinical Social Worker · Newbury, VT

NPI 1225807258 · NPPES record last updated Jul 28, 2025

Key facts

NPI
1225807258
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
089.0135588 (VT)
Practice address
4628 Main Street
Newbury, VT 05051-9172
Phone
(802) 222-3000
NPI assigned
Jan 2, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 9

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Little Rivers Health Care, Inc. (30 clinicians)

Practice addresses (Care Compare)

4628 Main St S
Newbury, VT 05051-9712
Phone (802) 866-3000

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240506003899 VT Practitioner - Clinical Social Worker 4789024811 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
089.0135588VTMDClinical Social Worker
3184NHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Rivers Health Care, Inc. Current
since Mar 20, 2024
Accepting new patients
Little Rivers Health Care, Inc. Current
since Mar 20, 2024
Accepting new patients
Little Rivers Health Care, Inc. Past Accepting new patients
Little Rivers Health Care, Inc. Past Accepting new patients
Little Rivers Health Care, Inc. Past Accepting new patients

Locations

4628 Main St S
Newbury, VT 05051
Phone (802) 866-3000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3184 NH
Clinical Social Worker 1041C0700X 089.0135588 VT Yes

Addresses

Primary practice location

4628 Main Street
Newbury, VT 05051-9172

Mailing address

4628 Main Street
PO Box 8
Newbury, VT 05051-9172
Phone (802) 222-3000

Other providers in Newbury, VT

All providers in Newbury, VT · Clinical Social Worker in Vermont

Sources for this page

Verify at the official NPI Registry.