Individual provider Active NPI

Stefanie Atwater, LISW

  • Clinical Social Worker
  • Yellow Springs, OH
National Provider Identifier
1689911786
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L.0900276 Issued in OH
Practice address
360 E Enon Rd
Yellow Springs, OH 45387-1415
Phone
(937) 767-1303
NPI assigned
Jan 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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 L.0900276 OH Primary

Addresses

Primary practice location

360 E Enon Rd
Yellow Springs, OH 45387-1415

Mailing address

1609 Mercer CT
Yellow Springs, OH 45387-1222
Phone (614) 499-6960

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
L.0900276OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Plum Creek Associates, Inc. Clinical Past Accepting new patients
Greene County Educational Service Center 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": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1689911786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 MERCER CT",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871222",
            "telephone_number": "614-499-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E ENON RD",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871415",
            "telephone_number": "937-767-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWATER",
        "first_name": "STEFANIE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "L.0900276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yellow Springs, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.