Active NPI
Michael Scott Stanley, LSW, CDCA
- Social Worker
- Gallipolis, OH
National Provider Identifier
1417437039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2207362
- Practice address
- 254 Pinecrest Dr
Gallipolis, OH 45631-1347 - Phone
- (740) 578-4824
- Fax
- (740) 578-4821
- NPI assigned
- Aug 14, 2018
- 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 | 167042 | OH | |
| Social Worker | 104100000X | S.2207362 | OH | Primary |
Addresses
Primary practice location
254 Pinecrest Dr
Gallipolis, OH 45631-1347
Mailing address
254 Pinecrest Dr
Gallipolis, OH 45631-1347
Phone (740) 578-4824
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 320087 | Medicaid | OH |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 167042 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| S.2207362 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1417437039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 PINECREST DR",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311347",
"telephone_number": "740-578-4824",
"fax_number": "740-578-4821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 PINECREST DR",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311347",
"telephone_number": "740-578-4824",
"fax_number": "740-578-4821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANLEY",
"first_name": "MICHAEL",
"middle_name": "SCOTT",
"credential": "LSW, CDCA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-14",
"last_updated": "2022-03-09",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "167042",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2207362",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "320087",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.