Individual provider Active NPI

Fred Lewis Stephens, LCSW

  • Clinical Social Worker
  • Oak Ridge, TN
National Provider Identifier
1356658165
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW0000006209 Issued in TN
Practice address
679B Emory Valley Rd
Oak Ridge, TN 37830-7756
Phone
(865) 383-0062
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSW0000006209 TN Primary

Addresses

Primary practice location

679B Emory Valley Rd
Oak Ridge, TN 37830-7756

Mailing address

1143 Oak Ridge Tpke Ste 107B
Ste 107B, PMB 274
Oak Ridge, TN 37830-6422
Phone (865) 383-0062

Other practice location 1

109 Caldwell Dr
Oak Ridge, TN 37830-7740
Phone (865) 383-0062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW0000006209TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Keith Albiston Past 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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1356658165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 OAK RIDGE TPKE STE 107B",
            "address_2": "STE 107B, PMB 274",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306422",
            "telephone_number": "865-383-0062",
            "fax_number": "865-280-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "679B EMORY VALLEY RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307756",
            "telephone_number": "865-383-0062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Caldwell Dr",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378307740",
            "country_code": "US",
            "telephone_number": "865-383-0062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "FRED",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000006209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.