Individual provider Active NPI

Lynne Marie Stanley, MSW, LCSW, ACSW, CTT

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1629246384
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C015469 Issued in NC
Practice address
7204 Algoa Bay LN
Wilmington, NC 28409-0500
Phone
(304) 830-2573
NPI assigned
Feb 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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 C015469 NC Primary

Addresses

Primary practice location

7204 Algoa Bay LN
Wilmington, NC 28409-0500

Mailing address

7204 Algoa Bay LN
Wilmington, NC 28409-0500
Phone (304) 830-2573

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherWVBCBS

Other names 1

  • Lynne Marie Manalac Stanley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241230001848 NC Practitioner - Clinical Social Worker 4183151350 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brightside Medical of New Jersey PCGroup PAC ID 5799141750, 61 clinicians

Practice addresses (Care Compare)

3064 Wake Forest Rd
Suite 1271
Raleigh, NC 27609-7844
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1629246384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7204 ALGOA BAY LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284090500",
            "telephone_number": "304-830-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7204 ALGOA BAY LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284090500",
            "telephone_number": "304-830-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "LYNNE",
        "middle_name": "MARIE",
        "credential": "MSW, LCSW, ACSW, CTT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PENDING",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNNE",
            "last_name": "MANALAC STANLEY",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.