Individual provider Active NPI

Stacey Jo Anderson, CSW-PIP

  • Clinical Social Worker
  • Rapid City, SD
National Provider Identifier
1508523150
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6635 Issued in SD
Practice address
2165 Promise Rd
Rapid City, SD 57701-8981
Phone
(605) 891-4499
NPI assigned
Nov 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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 6635 SD Primary

Addresses

Primary practice location

2165 Promise Rd
Rapid City, SD 57701-8981

Mailing address

2040 W Main St Ste 203
Rapid City, SD 57702-2446
Phone (605) 519-9523

Other practice location 1

8216 Chickadee Ln
Black Hawk, SD 57718-9512
Phone (605) 430-5221

Other practice location 2

2040 W Main St Ste 203
Rapid City, SD 57702-2446
Phone (605) 519-9523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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

Enrollment IDStateProvider typePAC IDDetails
I20260324001263 SD Practitioner - Clinical Social Worker 7719461144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2040 W Main St
Suite 203
Rapid City, SD 57702-2446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6635SDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Better You LLC Clinical CurrentSince Jul 28, 2025 Accepting new patients

Locations

2040 W Main St
Ste 203
Rapid City, SD 57702
Phone (605) 519-9523

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1508523150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 W MAIN ST STE 203",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022446",
            "telephone_number": "605-519-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 PROMISE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018981",
            "telephone_number": "605-891-4499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8216 Chickadee Ln",
            "address_purpose": "LOCATION",
            "city": "Black Hawk",
            "state": "SD",
            "postal_code": "577189512",
            "country_code": "US",
            "telephone_number": "605-430-5221",
            "fax_number": "605-430-5221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2040 W Main St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577022446",
            "country_code": "US",
            "telephone_number": "605-519-9523",
            "fax_number": "605-519-9523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STACEY",
        "middle_name": "JO",
        "credential": "CSW-PIP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "6635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.