Individual provider Active NPI

Douglas Wayne Stanley, MSW, LMSW. FAODP

  • Clinical Social Worker
  • Bloomfield Hills, MI
National Provider Identifier
1487812038
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090370 Issued in MI
Practice address
43902 Woodward Ave Ste 110
Bloomfield Hills, MI 48302-5021
Phone
(248) 338-1700
Fax
(248) 338-1732
NPI assigned
May 30, 2008
Last updated
Jun 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801090370 MI Primary

Addresses

Primary practice location

43902 Woodward Ave Ste 110
Bloomfield Hills, MI 48302-5021

Mailing address

10645 Highland Rd
White Lake, MI 48386-2147
Phone (248) 698-2250

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

State licenses

LicenseStateTypeSpecialty
6801090370MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Parker Clinic PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1487812038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10645 HIGHLAND RD",
            "city": "WHITE LAKE",
            "state": "MI",
            "postal_code": "483862147",
            "telephone_number": "248-698-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43902 WOODWARD AVE STE 110",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025021",
            "telephone_number": "248-338-1700",
            "fax_number": "248-338-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "DOUGLAS",
        "middle_name": "WAYNE",
        "credential": "MSW, LMSW. FAODP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.