Individual provider Active NPI

Stacy S Depriest, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1841508983
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2435-C Issued in NV
Practice address
1440 S Tenaya Way
Las Vegas, NV 89117-1528
Phone
(702) 340-8008
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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 2435-C NV Primary

Addresses

Primary practice location

1440 S Tenaya Way
Las Vegas, NV 89117-1528

Mailing address

PO Box 82130
Las Vegas, NV 89180-2130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2435-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1841508983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891802130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 S TENAYA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171528",
            "telephone_number": "702-340-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPRIEST",
        "first_name": "STACY",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "2435-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.