Individual provider Active NPI

Stacy K Odell, MSW

  • Social Worker
  • Parkersburg, WV
National Provider Identifier
1730973405
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
AP00943364 Issued in WV
Practice address
425 Juliana St
Parkersburg, WV 26101-5352
Phone
(304) 893-9777
NPI assigned
Apr 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X AP00943364 WV Primary

Addresses

Primary practice location

425 Juliana St
Parkersburg, WV 26101-5352

Mailing address

425 Juliana St
Parkersburg, WV 26101-5352
Phone (304) 893-9777

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

LicenseStateTypeSpecialty
AP00943364WVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clean and Clear Advantage CurrentSince Apr 13, 2025 Accepting new patients
Clean & Clear Advantage, LLC CurrentSince Apr 13, 2025 Accepting new patients

Locations

425 Juliana St
Parkersburg, WV 26101
Phone (304) 689-4334

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": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1730973405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 JULIANA ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015352",
            "telephone_number": "304-893-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 JULIANA ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "261015352",
            "telephone_number": "304-893-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "STACY",
        "middle_name": "K",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "AP00943364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.