Individual provider Active NPI

William Robert Stanley, LCSW

  • Clinical Social Worker
  • Louisville, KY
National Provider Identifier
1508909102
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
617 Issued in KY
Practice address
1027 Baxter Ave
Unit One
Louisville, KY 40204-1605
Phone
(502) 587-0711
Fax
(502) 587-0144
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 617 KY Primary

Addresses

Primary practice location

1027 Baxter Ave
Unit One
Louisville, KY 40204-1605

Mailing address

1027 Baxter Ave
Unit One
Louisville, KY 40204-1605
Phone (502) 587-0711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20051207000040 KY Practitioner - Clinical Social Worker 6406876366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1027 Baxter Ave
Unit 1
Louisville, KY 40204-1605
Phone (502) 741-7387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
617KYMDPsychologist

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508909102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 BAXTER AVE",
            "address_2": "UNIT ONE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041605",
            "telephone_number": "502-587-0711",
            "fax_number": "502-587-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 BAXTER AVE",
            "address_2": "UNIT ONE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041605",
            "telephone_number": "502-587-0711",
            "fax_number": "502-587-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.