Individual provider Active NPI

Stephanie Dorsey, LCSW

  • Clinical Social Worker
  • San Andreas, CA
National Provider Identifier
1629464532
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW113580 Issued in CA
Practice address
111 Main St Unit 37
San Andreas, CA 95249-9332
Phone
(209) 297-1911
NPI assigned
Apr 8, 2015
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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 LCSW113580 CA Primary

Addresses

Primary practice location

111 Main St Unit 37
San Andreas, CA 95249-9332

Mailing address

PO Box 1113
San Andreas, CA 95249-1113
Phone (209) 418-8628

Other identifiers 1

IdentifierTypeStateIssuer
0501MedicaidCA

Other names 1

  • Stephanie M Hatfield Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231026003910 CA Practitioner - Clinical Social Worker 8022464098 Reassigns benefits to 2 organizations
Practice locations: San Andreas, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

San Andreas, CA 95249
Phone (209) 297-1911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW113580CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stephanie Dorsey Licensed Clinical Social Worker PC Clinical CurrentSince Sep 8, 2025 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince May 1, 2025 Accepting new patients

Locations

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (323) 745-8323

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1629464532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1113",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952491113",
            "telephone_number": "209-418-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MAIN ST UNIT 37",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499332",
            "telephone_number": "209-297-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSEY",
        "first_name": "STEPHANIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW113580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0501",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HATFIELD",
            "middle_name": "M",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Andreas, CA

Sources for this page

Verify at the official NPI Registry.