Dese'Rae Lynn Stage, LCSW,MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

CW025097 Issued in PA

Practice address

701 E Cathedral Rd Ste 45-1395
Philadelphia, PA 19128-2128

Phone

(267) 532-4494

NPI assigned

Jun 1, 2022

Last updated

Oct 1, 2024By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Its Mine Movement, Inc

  • Mental Health Counselor
  • Garnet Valley, PA
  • NPI 1922672005
  NPD

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1396484168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 MERCER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253625",
            "telephone_number": "646-284-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E CATHEDRAL RD STE 45-1395",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282128",
            "telephone_number": "267-532-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGE",
        "first_name": "DESE'RAE",
        "middle_name": "LYNN",
        "credential": "LCSW,MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "CW025097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staffmore
• Brenda Arlene Stafford, MHS
• Kennedy Christine Stafford, DO, MS
• Lily Kathleen Stafford, MD, MPH
• Stafftech
• Stages Home Care LLC
• Alyson Stagg, CRNP
• Caroline Grace Stagliano, LSW
• Erica Stagliano, DO
• Regina Stahl

• Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.