Kim P Staneluis, LISW LICDC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I0001046 Issued in OH

Practice address

109 W Wayne St
Maumee, OH 43537-2150

Phone

(419) 893-8432

Fax

(419) 891-5403

NPI assigned

Nov 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Social Worker

Education

Other, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acorn Counseling LLCGroup PAC ID 9133290737, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acorn Counseling LLC

  • Clinical Social Worker
  • Maumee, OH
  • NPI 1851560577
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1770657579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W WAYNE ST",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435372150",
            "telephone_number": "419-893-8432",
            "fax_number": "419-891-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W WAYNE ST",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435372150",
            "telephone_number": "419-893-8432",
            "fax_number": "419-891-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANELUIS",
        "first_name": "KIM",
        "middle_name": "P",
        "credential": "LISW LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I0001046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Marks's Therapy Center
• Nicholas Richard St.John
• Christine Susanne Stahle, M.D.
• Maya Stallworth, RBT
• James M Staneluis, LPCC LICDC
• Katherine Elizabeth Stang
• Jeffery Steer, CSA
• Zachary Stephan
• Stephanie D McGuire Wise
• Courtney Elizabeth Stephens

• Social Worker in Maumee, OH
• Providers in Maumee, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.