Individual provider Active NPI

Stacey S Smith, LCSW

  • Clinical Social Worker
  • Norfolk, VA
National Provider Identifier
1730441296
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904007952 Issued in VA
Practice address
821 W 21St St Ste 209
Norfolk, VA 23517-1500
Phone
(757) 625-5598
Fax
(757) 585-3521
NPI assigned
Jun 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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 0904007952 VA Primary

Addresses

Primary practice location

821 W 21St St Ste 209
Norfolk, VA 23517-1500

Mailing address

208 Burleigh Ave
Norfolk, VA 23505-3413
Phone (757) 472-1379

Other names 1

  • Stacey O'Toole Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20130326000233 VA Practitioner - Clinical Social Worker 1951546886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bold Ruler LLCGroup PAC ID 2961833116, 3 clinicians

Practice addresses (Care Compare)

821 W 21St St
Suite 209
Norfolk, VA 23517-1500
Phone (757) 280-1777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bold Ruler, LLC Clinical CurrentSince Feb 11, 2025 Accepting new patients

Locations

821 W 21st St
Ste 209
Norfolk, VA 23517
Phone (757) 280-1777

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1730441296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 BURLEIGH AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235053413",
            "telephone_number": "757-472-1379",
            "fax_number": "757-585-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W 21ST ST STE 209",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235171500",
            "telephone_number": "757-625-5598",
            "fax_number": "757-585-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STACEY",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "O'TOOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.