Individual provider Active NPI

Stephanie Jo Rei, LCSW-BACS, C-SSWS

  • Clinical Social Worker
  • Haughton, LA
National Provider Identifier
1871744722
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14565 Issued in LA
Practice address
539 Dogwood South LN
Haughton, LA 71037-8554
Phone
(318) 540-8576
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 280429 AK
Clinical Social Worker 1041C0700X 14565 LA Primary

Addresses

Primary practice location

539 Dogwood South LN
Haughton, LA 71037-8554

Mailing address

539 Dogwood South LN
Haughton, LA 71037-8554
Phone (318) 540-8576

Other identifiers 1

IdentifierTypeStateIssuer
33-2957479OtherAWAKENING GRACE THERAPY LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: No
  • 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
I20250318001585 LA Practitioner - Clinical Social Worker 4880116037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14565LAMDClinical Social Worker
280429AKMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Awakening Grace Therapy LLC CurrentSince Feb 20, 2025 Accepting new patients
Transformation Through Grace Counseling LLC Clinical PastSince Jan 10, 2021 Accepting new patients
Easter Seals Alaska Past Accepting new patients

Locations

2123 Shed Rd
Ste 14
Bossier City, LA 71111
Phone (318) 540-8576

Organizations & group practices 3

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": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1871744722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 DOGWOOD SOUTH LN",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710378554",
            "telephone_number": "318-540-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 DOGWOOD SOUTH LN",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710378554",
            "telephone_number": "318-540-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REI",
        "first_name": "STEPHANIE",
        "middle_name": "JO",
        "credential": "LCSW-BACS, C-SSWS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AK",
            "license": "280429",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "14565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AWAKENING GRACE THERAPY LLC",
            "identifier": "33-2957479",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haughton, LA

Sources for this page

Verify at the official NPI Registry.