Individual provider Active NPI

Staci Lynn Allmand, LMSW

  • Clinical Social Worker
  • Fenton, MI
National Provider Identifier
1841479672
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801060575 Issued in MI
Practice address
10208 Carlee June Dr
Fenton, MI 48430-9531
Phone
(810) 632-2139
NPI assigned
Oct 29, 2007
Last updated
Oct 29, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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 6801060575 MI Primary

Addresses

Primary practice location

10208 Carlee June Dr
Fenton, MI 48430-9531

Mailing address

10208 Carlee June Dr
Fenton, MI 48430-9531
Phone (810) 632-2139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20181214001646 MI Practitioner - Clinical Social Worker 4082959325 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Coverage Services PC CurrentSince Dec 2, 2018 Accepting new patients
Quality Innovation Services Clinical PastSince Feb 8, 2023 Accepting new patients

Locations

2700 Robert T Longway Blvd
Ste B
Flint, MI 48503
Phone (810) 235-2004

Organizations & group practices 2

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": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1841479672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10208 CARLEE JUNE DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309531",
            "telephone_number": "810-632-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 CARLEE JUNE DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309531",
            "telephone_number": "810-632-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLMAND",
        "first_name": "STACI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801060575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.