Active NPI
Stacey Marie Gappa, LCSW, LMSW
- Social Worker
- Edwardsburg, MI
National Provider Identifier
1720202674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801106723
- Practice address
- 70239 Beach Dr
Edwardsburg, MI 49112-9436 - Phone
- (574) 302-6094
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 34008919A | IN | |
| Social Worker | 104100000X | 6801106723 | MI | Primary |
Addresses
Primary practice location
70239 Beach Dr
Edwardsburg, MI 49112-9436
Mailing address
70239 Beach Dr
Edwardsburg, MI 49112-9436
Phone (574) 302-6094
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801106723 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715644800000",
"number": "1720202674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70239 BEACH DR",
"city": "EDWARDSBURG",
"state": "MI",
"postal_code": "491129436",
"telephone_number": "574-302-6094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70239 BEACH DR",
"city": "EDWARDSBURG",
"state": "MI",
"postal_code": "491129436",
"telephone_number": "574-302-6094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAPPA",
"first_name": "STACEY",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LCSW, LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2024-05-14",
"certification_date": "2024-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "34008919A",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801106723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edwardsburg, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.