NPIMap

Organization Active NPI

Tracy Stubblefield LLC

  • Clinical Social Worker
  • Largo, MD
National Provider Identifier
1346557402
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15332 Issued in MD
Legal business name
TRACY STUBBLEFIELD LLC
Practice address
9701 Apollo Dr
Suite 441
Largo, MD 20774-4783
Phone
(240) 764-6892
Fax
(240) 764-6741
NPI assigned
Sep 9, 2010
Last updated
Nov 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Authorized official

Name
Ms. Tracy R Stubblefield, MSW
Title
LCSW-C
Phone
(240) 764-6892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 15332 MD Primary

Addresses

Primary practice location

9701 Apollo Dr
Suite 441
Largo, MD 20774-4783

Mailing address

4630 Hayes Street NE
Washington, DC 20019-3611
Phone (240) 764-6892

Other identifiers 1

IdentifierTypeStateIssuer
15332OtherMDLICENSE # 15332

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1346557402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 HAYES STREET NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193611",
            "telephone_number": "240-764-6892",
            "fax_number": "240-764-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 APOLLO DR",
            "address_2": "SUITE 441",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744783",
            "telephone_number": "240-764-6892",
            "fax_number": "240-764-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY STUBBLEFIELD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "STUBBLEFIELD",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "LCSW-C",
        "authorized_official_telephone_number": "240-764-6892",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "15332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE # 15332",
            "identifier": "15332",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.