Individual provider Active NPI

Stacey Dutro, LMSW

  • Clinical Social Worker
  • Lenexa, KS
National Provider Identifier
1851571368
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6343 Issued in KS
Practice address
12351 W 96TH Ter
300
Lenexa, KS 66215-4409
Phone
(913) 894-0900
Fax
(913) 894-0908
NPI assigned
Nov 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 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 6343 KS Primary

Addresses

Primary practice location

12351 W 96TH Ter
300
Lenexa, KS 66215-4409

Mailing address

12351 W 96TH Ter
300
Lenexa, KS 66215-4409
Phone (913) 894-0900

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
6343KSMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1851571368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12351 W 96TH TER",
            "address_2": "300",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662154409",
            "telephone_number": "913-894-0900",
            "fax_number": "913-894-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12351 W 96TH TER",
            "address_2": "300",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662154409",
            "telephone_number": "913-894-0900",
            "fax_number": "913-894-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTRO",
        "first_name": "STACEY",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "6343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.