Individual provider Active NPI

Stacy F Messmer, LCSW

  • Clinical Social Worker
  • Mineola, NY
National Provider Identifier
1790074920
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086688 Issued in NY
Practice address
110 Main St
Mineola, NY 11501-4000
Phone
(516) 747-5644
Fax
(516) 747-2556
NPI assigned
Mar 28, 2011
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 080001 NY
Clinical Social Worker 1041C0700X 086688 NY Primary

Addresses

Primary practice location

110 Main St
Mineola, NY 11501-4000

Mailing address

110 Main St
Mineola, NY 11501-4000
Phone (516) 747-5644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20210713002642 NY Practitioner - Clinical Social Worker 9638571698 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

135 Vanderbilt Ave
Staten Island, NY 10304-2604
Phone (800) 275-3243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080001NYMDSocial Worker
086688NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Aug 10, 2021 Accepting new patients
Knapp Street Psychiatry, PC Clinical CurrentSince Aug 11, 2021 Accepting new patients
Michelle Listens LCSW, PC Clinical CurrentSince Dec 5, 2023 Accepting new patients
Christopher Dennis MD PLLC Clinical CurrentSince Jun 1, 2021 Accepting new patients
Tal Mednick MD PC PastSince Apr 23, 2023 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

350 Veterans Memorial Hwy
Ste 2
Commack, NY 11725
Phone (516) 344-7975

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

100 Park Ave
Fl 16
New York, NY 10017
Phone (212) 433-2384

510 Clinton Sq
Rochester, NY 14604
Phone (561) 208-1970

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1790074920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAIN ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014000",
            "telephone_number": "516-747-5644",
            "fax_number": "516-747-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014000",
            "telephone_number": "516-747-5644",
            "fax_number": "516-747-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSMER",
        "first_name": "STACY",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "080001",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.