Stacy Robin Telli, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004264 Issued in NC

Practice address

1091 Pemberton Hill Rd Ste 102
Apex, NC 27502-4269

Phone

(919) 303-0273

Fax

(919) 303-5986

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245249606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 PEMBERTON HILL RD STE 102",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024269",
            "telephone_number": "919-303-0273",
            "fax_number": "919-303-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 PEMBERTON HILL RD STE 102",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024269",
            "telephone_number": "919-303-0273",
            "fax_number": "919-303-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLI",
        "first_name": "STACY",
        "middle_name": "ROBIN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE NUMBER",
            "identifier": "C004264",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "134KM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Apex, NC
• Providers in Apex, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.