Stacey Lynn-Churchill Smyczynski, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801104994 Issued in MI

Practice address

1025 W Washington St Ste B
Marquette, MI 49855-4031

Phone

(989) 267-0071

Fax

(989) 267-0230

NPI assigned

Oct 7, 2020

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Caught Dreamin' Therapy, LLC

  • Adult Mental Health Clinic/Center
  • Marquette, MI
  • NPI 1861122152

  Clinical

  NPD

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1831796499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 W CARPENTER ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404339",
            "telephone_number": "989-878-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W WASHINGTON ST STE B",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554031",
            "telephone_number": "989-267-0071",
            "fax_number": "989-267-0230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1511 W Carpenter St",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486404339",
            "country_code": "US",
            "telephone_number": "989-878-1716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMYCZYNSKI",
        "first_name": "STACEY",
        "middle_name": "LYNN-CHURCHILL",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801104994",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Elizabeth Smith
• Randolph Edward Smith, MD
• Ryan J Smith, LBSW
• Rylee Chantel Smith, APRN, CNP
• Tiffany Ann Smith, QIDP, HS-BCP
• Donald E Snowdon, M.D.
• Milton D Soderberg, MD
• Solace and Grace Counseling LLC
• Matthew Newberg Songer, MD
• Sonnie Gobert Mental Health Therapy Services

• Clinical Social Worker in Marquette, MI
• Providers in Marquette, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.