Stacey Leah Pacouloute, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14435 Issued in FL

Practice address

1100 NW 100TH St
Miami, FL 33150-1539

Phone

(786) 247-3760

NPI assigned

Sep 13, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677974400000",
    "number": "1841773033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NW 100TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331501539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NW 100TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331501539",
            "telephone_number": "786-247-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACOULOUTE",
        "first_name": "STACEY",
        "middle_name": "LEAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2023-03-05",
        "certification_date": "2023-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "113935",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928717",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06153900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "14435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Rehabilitation Center
• Pacific Rehabilitation Center, Inc.
• Greter Pacios, PMHNP-BC
• Jenny Vanessa Packard
• Stacey Packman, ARNP
• Sigmund Joseph Paczkowski, DO
• Aakash Satvik Padakandla, MD
• Hernando J. Padaui, FMD
• Kyle Padgett, PHD
• Yasdany Padilla Aguiar

• Clinical Social Worker in Miami, FL
• Providers in Miami, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2023; 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.