Bethany Stacey

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801121761 Issued in MI

Practice address

1939 Division Ave S
Grand Rapids, MI 49507-2480

Phone

(616) 247-3815

NPI assigned

May 3, 2023

Last updated

Feb 23, 2026By 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

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kent County CMH AuthorityGroup PAC ID 9436314143, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Kent County CMH Authority

  dba Network 180

  • Community/Behavioral Health Agency
  • Grand Rapids, MI
  • NPI 1588935068
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1497444624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 DIVISION AVE S",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 DIVISION AVE S",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072480",
            "telephone_number": "616-247-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "BETHANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801121761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Ann's Home Inc.
• St. Lukes Primary Care
• Arielle Leigh St. Pierre
• Heather Staal
• Stacey Vanderklok, LLC
• Camryn N Stacey
• Gregory Stacey, RD
• William Delano Stacey, LLMSW, CAAC
• Kristen M Stache, RD
• Jeffrey W Stachel, D.D.S.

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.