Individual provider Active NPI

Stacey Tarase Holley, LCSW-C

  • Clinical Social Worker
  • Nottingham, MD
National Provider Identifier
1669308748
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28982 Issued in MD
Practice address
20 Juliet LN
Nottingham, MD 21236-1233
Phone
(410) 382-0379
NPI assigned
Jun 18, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 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 WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 28982 MD Primary

Addresses

Primary practice location

20 Juliet LN
Nottingham, MD 21236-1233

Mailing address

20 Juliet LN
Nottingham, MD 21236-1233
Phone (410) 382-0379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1781740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1669308748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 JULIET LN",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212361233",
            "telephone_number": "410-382-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 JULIET LN",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212361233",
            "telephone_number": "410-382-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEY",
        "first_name": "STACEY",
        "middle_name": "TARASE",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-18",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "28982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.