Stacy Prince Park, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1219 Issued in TN

Practice address

240 W Tyrone Rd
Oak Ridge, TN 37830-6517

Phone

(865) 482-1076

Fax

(865) 481-6179

NPI assigned

Nov 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326115916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W TYRONE RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306517",
            "telephone_number": "865-482-1076",
            "fax_number": "865-481-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W TYRONE RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306517",
            "telephone_number": "865-482-1076",
            "fax_number": "865-481-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "STACY",
        "middle_name": "PRINCE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "1219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pain Management, PLLC
• Joseph Palatinus, M.D.
• Rebecca Mims Palmer, LCSW
• April Misa Park, PA-C
• Seongman Park, PA-C
• Claudia Jane Parker
• Lyndsey C Parker, PA
• Parkway Cardiology Associates P C
• Graeme Matthew Parsons, FNP-C
• Shiela Jasmin Pasco, PHARMD

• Clinical Social Worker in Oak Ridge, TN
• Providers in Oak Ridge, TN by specialty
• Clinical Social Worker in Tennessee

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.