Christine F Stacey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004960A

Practice address

2106 Ironwood Cir
South Bend, IN 46635-1864

Phone

(574) 243-9370

Fax

(574) 243-9375

NPI assigned

Oct 13, 2005

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Intrigue Counseling, Inc

  • Clinical Social Worker
  • South Bend, IN
  • NPI 1841248754
  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1558359489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 IRONWOOD CIR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351864",
            "telephone_number": "574-243-9370",
            "fax_number": "574-243-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 IRONWOOD CIR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351864",
            "telephone_number": "574-243-9370",
            "fax_number": "574-243-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "CHRISTINE",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "34004960A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Joseph'S Regional Medical Center
• Ritchie St-Jean, RBT
• St. Joseph Co. Airport Authority
• St. Joseph County Auditor
• Susan M St. Ville, PH.D., MSW, LCSW
• Diane M Stacker, O.T.
• Samantha Morgan Stacy
• Jack Staddon, M.D., PH.D.
• Kaleigh Renee Stafford
• Cheryl Ann Stahl, FNP-BC

• Clinical Social Worker in South Bend, IN
• Providers in South Bend, 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 18, 2008; 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.