NPIMap

Organization Active NPI

Stacey J Rutherford, Licsw P.C.

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1790842052
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
110648 Issued in MA
Legal business name
STACEY J RUTHERFORD, LICSW P.C.
Practice address
198 Russell St
Worcester, MA 01609-2200
Phone
(508) 438-0110
NPI assigned
Jan 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stacey Jenee Rutherford, LICSW, MSWNPI 1528168135
Title
President
Phone
(508) 438-0110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 110648 MA Primary

Addresses

Primary practice location

198 Russell St
Worcester, MA 01609-2200

Mailing address

198 Russell St
Worcester, MA 01609-2200
Phone (508) 438-0110

National Provider Directory

National Provider Directory

Locations

198 Russell St
Worcester, MA 01609
Phone (508) 438-0110

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790842052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 RUSSELL ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092200",
            "telephone_number": "508-438-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 RUSSELL ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092200",
            "telephone_number": "508-438-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY J RUTHERFORD, LICSW P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUTHERFORD",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "JENEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-438-0110",
        "authorized_official_credential": "LICSW, MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.