Individual provider Active NPI

Stacey Scanlon, LMSW

  • Social Worker
  • Las Cruces, NM
National Provider Identifier
1285059493
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
X-08397 Issued in NM
Practice address
530 Corona del Campo Loop
Las Cruces, NM 88011-4047
Phone
(575) 312-4206
NPI assigned
Feb 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X X-08397 NM Primary

Addresses

Primary practice location

530 Corona del Campo Loop
Las Cruces, NM 88011-4047

Mailing address

530 Corona del Campo Loop
Las Cruces, NM 88011-4047
Phone (575) 312-4206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20210510002039 NM Practitioner - Clinical Social Worker 7214345925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X-08397NMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rise Up Counseling Services LLC Social Worker CurrentSince Mar 10, 2021 Accepting new patients

Organizations & group practices 1

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": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1285059493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 CORONA DEL CAMPO LOOP",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114047",
            "telephone_number": "575-312-4206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 CORONA DEL CAMPO LOOP",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114047",
            "telephone_number": "575-312-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "STACEY",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "X-08397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.