Stacey R Ezersky, LCSW C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13400 Issued in MD

Practice address

3635 Old Court Rd Ste 305
Pikesville, MD 21208-3907

Phone

(443) 898-8308

Fax

(443) 327-4753

NPI assigned

Feb 21, 2007

Last updated

Jan 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Stacey R Sell Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• For the Healing of the Nations LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pikesville, MD
  • NPI 1417476607
  NPD
• Maryland Psychotherapy Services LLC

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1750424081
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1689709800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3635 OLD COURT RD STE 305",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212083907",
            "telephone_number": "443-898-8308",
            "fax_number": "443-327-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 OLD COURT RD STE 305",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212083907",
            "telephone_number": "443-898-8308",
            "fax_number": "443-327-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZERSKY",
        "first_name": "STACEY",
        "middle_name": "R",
        "credential": "LCSW  C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412244500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "SELL",
            "middle_name": "R",
            "prefix": "MS.",
            "credential": "LCSW C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Express Yourself Mental Health Services LLC (Express Yourself Mental Health Services)
• Eye Care Associates of MD, LLC
• Eye Care Associates of MD, LLC
• Chinne Ezeigwe, DPT
• Janelle Ezenwajiaku
• F B & O Baby and Elderly Care Agency LLC
• Eleanor M Fabic
• Olivia Marie Facey
• Iyabode O Fadeyi, M.ED., LCPC
• Tara S Fahnestock

• Clinical Social Worker in Pikesville, MD
• Providers in Pikesville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.