Individual provider Active NPI

Stacy Moore-Nolan, LCSW

  • Clinical Social Worker
  • Jasper, IN
National Provider Identifier
1649260522
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004949A Issued in IN
Practice address
480 Eversman Dr
Jasper, IN 47546-3548
Phone
(812) 482-3020
Fax
(812) 482-6409
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 34004949A IN Primary

Addresses

Primary practice location

480 Eversman Dr
Jasper, IN 47546-3548

Mailing address

PO Box 769
Jasper, IN 47547-0769
Phone (812) 482-3020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20050405000925 IN Practitioner - Clinical Social Worker 0143277863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespring, IncGroup PAC ID 5294624508, 65 clinicians

Practice addresses (Care Compare)

460 Spring St
Jeffersonville, IN 47130-3452
Phone (812) 280-2080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34004949AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespring, Inc CurrentSince Sep 10, 2018 Accepting new patients
Lifespring, Inc CurrentSince Sep 10, 2018 Accepting new patients

Locations

480 Eversman Dr
Ste 1
Jasper, IN 47546

480 Eversman Dr
Jasper, IN 47546
Phone (812) 482-3020

1036 Sharon Dr
Jeffersonvlle, IN 47130
Phone (812) 258-9281

460 Spring St
Jeffersonvlle, IN 47130
Phone (812) 280-3583

488 W Hospital Rd
Paoli, IN 47454
Phone (812) 723-4301

1443 9th St
Tell City, IN 47586
Phone (812) 547-7905

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1649260522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475470769",
            "telephone_number": "812-482-3020",
            "fax_number": "812-482-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 EVERSMAN DR",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463548",
            "telephone_number": "812-482-3020",
            "fax_number": "812-482-6409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE-NOLAN",
        "first_name": "STACY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004949A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

Verify at the official NPI Registry.