Stacy Renea Brackins, RSST

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801100978 Issued in MI

Practice address

700 E Grand Blvd
Detroit, MI 48207-2526

Phone

(313) 702-1301

NPI assigned

Oct 9, 2012

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1346592771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15411 MONTE VISTA ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381007",
            "telephone_number": "313-434-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072526",
            "telephone_number": "313-702-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKINS",
        "first_name": "STACY",
        "middle_name": "RENEA",
        "name_prefix": "Ms.",
        "credential": "RSST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801100978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Ann Bracey, RN
• Jordan M. Braciszewski, PH.D.
• Amir Kamal Bracken Sr., MA, SST
• Timothy James Bracken, RRT
• Yvette Brackett, RN
• Abigail Ruth Brackney, MD
• Leslie Marie Braden, MS, LLP
• Marquisse Bradford- Classen
• Callie Constance Bradford
• Elyse Wiseman Bradford, BCBA

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.