Stacy Ann Wetters, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

088312 Issued in NY

Practice address

22170 W 9 Mile Rd
Southfield, MI 48033-6007

Phone

(248) 372-6800

Fax

(248) 357-9465

NPI assigned

Sep 14, 2011

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

Other names 1

• Mrs. Stacy Ann Guy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1851673990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22170 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480336007",
            "telephone_number": "248-372-6800",
            "fax_number": "248-357-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22170 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480336007",
            "telephone_number": "248-372-6800",
            "fax_number": "248-357-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTERS",
        "first_name": "STACY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-14",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090172",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "088312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "GUY",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hannah West
• Westbrooke Medical Center
• Donna Sue Westmoreland, APRN, FNP-BC, ACHPN
• Marcia Weston
• Mia Weston
• Burt Weyhing, MD
• Juli A Whalen, CRNA
• Natakki Wheatley, M.D.
• Teryn Wheatley
• Belle Wherry

• Clinical Social Worker in Southfield, MI
• Providers in Southfield, 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 Sep 4, 2020; 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.