Stacey Speelman, LISW-S, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60554699 Issued in WA

Practice address

6060 Portal Way
Ferndale, WA 98248-7833

Phone

(360) 676-6177

NPI assigned

Apr 24, 2015

Last updated

Jul 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stacey Renee Gooding Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1760879910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE STE 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254642",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 PORTAL WAY",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982487833",
            "telephone_number": "360-676-6177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Unity St",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982254429",
            "country_code": "US",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPEELMAN",
        "first_name": "STACEY",
        "credential": "LISW-S, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1200679",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60554699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "GOODING",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deborah A Smith, PMHNP-BC
• Jewell Smith, M.S.,L.AC., LMP
• Karlee Nicole Smith, LMHCA
• Walter Kalani Snyder, M.D.
• Sound Nursing
• Elizabeth Steensland, M.A. CF-SLP
• Fawn M Sterling-Collins
• Rachelle Stewart, RN
• Suzanne Elizabeth Stratford, OTR/L
• Karri J Street, LMP

• Clinical Social Worker in Ferndale, WA
• Providers in Ferndale, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.