Individual provider Active NPI

Stephanie Dion Spears, LCSW

  • Clinical Social Worker
  • McComb, MS
National Provider Identifier
1679722904
Registry record updated Mar 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C4649 Issued in MS
Practice address
300 Rawls Dr Ste 900
McComb, MS 39648-2864
Phone
(601) 730-4401
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2019

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 C4649 MS Primary

Addresses

Primary practice location

300 Rawls Dr Ste 900
McComb, MS 39648-2864

Mailing address

1037 Bill Bacot Rd
McComb, MS 39648-8459
Phone (601) 551-1868

Other practice location 1

420 Delaware Ave
McComb, MS 39648-4021
Phone (601) 684-4009

Other identifiers 1

IdentifierTypeStateIssuer
05187326MedicaidMS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C4649MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Stones Testing & Therapy Services, PLLC Clinical PastSince Aug 9, 2020 Accepting new patients
Chris M Huff LCSW PLLC Clinical Past Accepting new patients

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": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1679722904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 BILL BACOT RD",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396488459",
            "telephone_number": "601-551-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RAWLS DR STE 900",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482864",
            "telephone_number": "601-730-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 DELAWARE AVE",
            "address_purpose": "LOCATION",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396484021",
            "country_code": "US",
            "telephone_number": "601-684-4009",
            "fax_number": "601-684-4039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEARS",
        "first_name": "STEPHANIE",
        "middle_name": "DION",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C4649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05187326",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.