Active NPI
David Frank Stouse, MA, LCSW, MAC
- Clinical Social Worker
- Kokomo, IN
National Provider Identifier
1407862576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34002664A
- Practice address
- 1907 W Sycamore St
Kokomo, IN 46904-9010 - Phone
- (765) 456-5900
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 87000615A | IN | |
| Clinical Social Worker | 1041C0700X | 34002664A | IN | Primary |
Addresses
Primary practice location
1907 W Sycamore St
Kokomo, IN 46904-9010
Mailing address
10330 N Meridian St # 300
Indianapolis, IN 46290-1024
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6227695 | Other | IN | UBH ID NUMBER |
| STOUS-0001 | Other | IN | COMPCARE ID NUMBER |
| 083845-000 | Other | IN | MAGELLAN ID NUMBER |
| 11347605 | Other | IN | CAQH IDENTIFICATION NUMBE |
| 2200696 | Other | IN | CIGNA/VALUEOPTIONS ID # |
| 000000343506 | Other | IN | ANTHEM BX/BS ID NUMBER |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87000615A | IN | MD | Addiction (Substance Use Disorder) Counselor |
| 34002664A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522886400000",
"number": "1407862576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10330 N MERIDIAN ST # 300",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462901024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 W SYCAMORE ST",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469049010",
"telephone_number": "765-456-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOUSE",
"first_name": "DAVID",
"middle_name": "FRANK",
"name_prefix": "Mr.",
"credential": "MA, LCSW, MAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2018-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "87000615A",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34002664A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH ID NUMBER",
"identifier": "6227695",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPCARE ID NUMBER",
"identifier": "STOUS-0001",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN ID NUMBER",
"identifier": "083845-000",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH IDENTIFICATION NUMBE",
"identifier": "11347605",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA/VALUEOPTIONS ID #",
"identifier": "2200696",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BX/BS ID NUMBER",
"identifier": "000000343506",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.