Stephanie Joy Mestery, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3516 Issued in ND

Practice address

6046 14TH St S
Fargo, ND 58104-7340

Phone

(701) 404-0997

Fax

(701) 566-8876

NPI assigned

Jul 19, 2016

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

Medicare fee-for-service enrollment

Enrolled in ND

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

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 and National Provider Directory roles.

• SJM Counseling PLLC

  • Clinical Social Worker
  • Fargo, ND
  • NPI 1639760937
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1770936254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6046 14TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047340",
            "telephone_number": "701-404-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6046 14TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047340",
            "telephone_number": "701-404-0997",
            "fax_number": "701-566-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESTERY",
        "first_name": "STEPHANIE",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ND",
            "license": "3516",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Brooke Mertz, RD
• Taylor Elizabeth Mertz, CNM
• Cory Richard Messer
• Shaunna Messmer-Lavalley, PT, DPT
• Amy Messner, LBSW
• Andrea Metcalf
• Jacob Metcalf
• Metro Area Transit
• Metro Drug Co
• Nora Mettler, NNP-BC

• Clinical Social Worker in Fargo, ND
• Providers in Fargo, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.