Stacey Lynn Casanova, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801079359 Issued in MI

Practice address

1200 N West Ave
Suite 800
Jackson, MI 49202-2179

Phone

(517) 780-3304

Fax

(517) 787-1765

NPI assigned

Apr 12, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1750505855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 FAIRVIEW AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492032409",
            "telephone_number": "517-392-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "address_2": "SUITE 800",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-780-3304",
            "fax_number": "517-787-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASANOVA",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801079359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE SOCIAL WORK LICENSE",
            "identifier": "6801079359",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cliff J Carter, O.D.
• Ebony Renee Carter, LMSW
• Jane Carter
• Michael Cole Carter, DO
• Diane Nicole Cary, CHW
• Cascade Plastic Surgery PLC
• Cascade Senior Care Center LLC
• Cascades Orthopedic Rehabilitation Services
• Cascades Orthopedic Rehabilitation Services Inc
• Cascades Urology P.C.

• Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; 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.