Organization Active NPI

Tammy Stabosz LCSW PLLC

  • Clinical Social Worker
  • Fairview, NC
National Provider Identifier
1679434997
Registry record updated Nov 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
TAMMY STABOSZ LCSW PLLC
Practice address
76 Ashworth Dr
Fairview, NC 28730-9229
Phone
(815) 412-4003
NPI assigned
Nov 18, 2025
Last updated
Nov 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tamara Ann Stabosz, LCSWNPI 1760021513
Title
Owner
Phone
(815) 412-4003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

76 Ashworth Dr
Fairview, NC 28730-9229

Mailing address

76 Ashworth Dr
Fairview, NC 28730-9229
Phone (815) 412-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260109001456 NC Part B Supplier - Clinic/Group Practice 3678059615 Receives reassigned benefits from 1 practitioner
Practice locations: Fairview, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764460800000",
    "number": "1679434997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 ASHWORTH DR",
            "city": "FAIRVIEW",
            "state": "NC",
            "postal_code": "287309229",
            "telephone_number": "815-412-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 ASHWORTH DR",
            "city": "FAIRVIEW",
            "state": "NC",
            "postal_code": "287309229",
            "telephone_number": "815-412-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMMY STABOSZ LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-30",
        "certification_date": "2025-11-30",
        "status": "A",
        "authorized_official_last_name": "STABOSZ",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-412-4003",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.