Individual provider Active NPI

Denise Burton Stanley, MSW, LCSW

  • Clinical Social Worker
  • Kodiak, AK
National Provider Identifier
1801981170
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
975 Issued in AK
Practice address
717 E Rezanof Dr
Kodiak, AK 99615-6416
Phone
(907) 481-2400
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 975 AK Primary

Addresses

Primary practice location

717 E Rezanof Dr
Kodiak, AK 99615-6416

Mailing address

500B Cape Decision St
Kodiak, AK 99615-6817
Phone (907) 512-3059

Other identifiers 2

IdentifierTypeStateIssuer
975OtherAKALASKA LCSW LICENSE NUMBER
C005352OtherNCNC LCSW LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20200924001615 SC Practitioner - Clinical Social Worker 1456452820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

112 B Bypass
Suite 225
Greenwood, SC 29646-1154
Phone (864) 450-1570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
975AKMDPharmacist
10338SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Denise B. Stanley, Lisw-CP, LLC Clinical CurrentSince Aug 14, 2020 Accepting new patients

Locations

112B Bypass 225
Greenwood, SC 29646
Phone (864) 450-1570

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1801981170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500B CAPE DECISION ST",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156817",
            "telephone_number": "907-512-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156416",
            "telephone_number": "907-481-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "DENISE",
        "middle_name": "BURTON",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA LCSW LICENSE NUMBER",
            "identifier": "975",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC LCSW LICENSE NUMBER",
            "identifier": "C005352",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kodiak, AK

Sources for this page

Verify at the official NPI Registry.