Individual provider Active NPI

Debra K Stanley, LCSW

  • Mental Health Counselor
  • Arcadia, FL
National Provider Identifier
1700668233
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW10948 Issued in FL
Practice address
725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752
Phone
(634) 941-2428
Fax
(863) 491-0466
NPI assigned
Oct 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW10948 FL
Mental Health Counselor 101YM0800X SW10948 FL Primary

Addresses

Primary practice location

725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752

Mailing address

3740 Whiteway Dairy Rd
Fort Pierce, FL 34947-6339
Phone (954) 993-4635

Other practice location 1

3740 Whiteway Dairy Rd
Fort Pierce, FL 34947-6339
Phone (954) 993-4635

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231026003722 FL Practitioner - Clinical Social Worker 9234585209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW10948FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. CurrentSince Apr 10, 2024 Accepting new patients
Balanced Wellbeing LLC Clinical CurrentSince Oct 16, 2023 Accepting new patients
MCR Health, Inc. CurrentSince Apr 10, 2024 Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1700668233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 WHITEWAY DAIRY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349476339",
            "telephone_number": "954-993-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N 12TH AVE BLDG B",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668752",
            "telephone_number": "634-941-2428",
            "fax_number": "863-491-0466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3740 Whiteway Dairy Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349476339",
            "country_code": "US",
            "telephone_number": "954-993-4635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "DEBRA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10948",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW10948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, FL

Sources for this page

Verify at the official NPI Registry.