Individual provider Active NPI

Stanley Stanczak, MSW

  • Clinical Social Worker
  • Roseville, MI
National Provider Identifier
1699824904
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801001259 Issued in MI
Practice address
25869 Kelly Rd
Suite a
Roseville, MI 48066-4997
Phone
(586) 773-6020
Fax
(586) 773-6093
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801001259 MI Primary

Addresses

Primary practice location

25869 Kelly Rd
Suite a
Roseville, MI 48066-4997

Mailing address

25869 Kelly Rd
Suite a
Roseville, MI 48066-4997
Phone (586) 773-6020

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

Practice roles

OrganizationSpecialtyStatusNew patients
Biological Psychiatry Center, PC Clinical PastSince Jan 1, 2005 Accepting new patients

Organizations & group practices 1

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699824904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25869 KELLY RD",
            "address_2": "SUITE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664997",
            "telephone_number": "586-773-6020",
            "fax_number": "586-773-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25869 KELLY RD",
            "address_2": "SUITE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664997",
            "telephone_number": "586-773-6020",
            "fax_number": "586-773-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANCZAK",
        "first_name": "STANLEY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801001259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.