Christy Stack, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04407400 Issued in NJ

Practice address

101 E Gate Dr
Cherry Hill, NJ 08034-2803

Phone

(856) 810-7599

Fax

(856) 810-7662

NPI assigned

Sep 29, 2016

Sex

Female

Sole proprietor

Yes

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

Enrolled in NJ

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

Specialty

Clinical Social Worker

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Interactive Kids, LLC

  • Behavior Analyst
  • Cherry Hill, NJ
  • NPI 1740508944
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1376092478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N VENDOME AVE",
            "city": "MARGATE CITY",
            "state": "NJ",
            "postal_code": "084021246",
            "telephone_number": "609-839-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E GATE DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342803",
            "telephone_number": "856-810-7599",
            "fax_number": "856-810-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "CHRISTY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04407400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Springstead, MD
• Stacey Lynn Spuler, OT
• Brigid Squilla, CRNA
• SRS-Cherry Hill LLC (Sanderling Dialysis - Cherry HIll)
• Jaime Marie Stabile, PT
• Meghan Stack
• Anna Marie Stadtmueller, PSY.D.
• Staffing Plus
• Frank J. Stafford I, APN
• Patricia T. Stafford, MD

• Clinical Social Worker in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.