Pamela Jean Stacy, LCSW, RN

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34006033A Issued in IN

Practice address

720 N Marr Rd
Columbus, IN 47201-6660

Phone

(812) 314-3400

Fax

(812) 376-4875

NPI assigned

Mar 8, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1477521466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691",
            "fax_number": "812-337-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N MARR RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016660",
            "telephone_number": "812-314-3400",
            "fax_number": "812-376-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACY",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "credential": "LCSW, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "28142163A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006033A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spine Care P.C.
• Hanna Spradlin
• Elizabeth Sprague, RBT
• Revathe Sree Sri Kumar
• Aishwarya Sriraman, RBT
• Joy Stagg, MSW
• Gerald Joseph Stahl, DDS
• Joshua Stahley, M.DIV.
• Joshua E. Stanley, LCSW
• Raymond Mark Stanton, BCHIS

• Clinical Social Worker in Columbus, IN
• Providers in Columbus, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.