Stacey Lyn Todd, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904010208 Issued in VA

Practice address

2965 Colonnade Dr Ste 100
Roanoke, VA 24018-3541

Phone

(540) 989-1703

Fax

(540) 989-1705

NPI assigned

Nov 27, 2017

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 VA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Blue Ridge Behavioral Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roanoke, VA
  • NPI 1437137734
  Medicare reassignment NPD

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396259461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 BARRENS VILLAGE CT",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240192344",
            "telephone_number": "540-819-5579",
            "fax_number": "540-989-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 COLONNADE DR STE 100",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183541",
            "telephone_number": "540-989-1703",
            "fax_number": "540-989-1705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2965 Colonnade Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240183541",
            "country_code": "US",
            "telephone_number": "540-989-1703",
            "fax_number": "540-989-1705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODD",
        "first_name": "STACEY",
        "middle_name": "LYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Danielle Titak
• Rebin Thomas Titus, M.D.
• TLC VC, LLC
• Hosai N Todd Hesham, MD
• Jeffrey S. Todd, M.D.
• Sandra Lyn Toensing, P.A.C
• Matthew D Togo, O.T.
• Katherine Jane Tolhurst, M.D.
• Sharon Kay Toliver-Hardy, LCSW
• Sharon Tolley

• Clinical Social Worker in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.