Stacey Jane Wakeley, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801087145 Issued in MI

Practice address

2782 S Otsego Ave
Gaylord, MI 49735-9404

Phone

(989) 732-7525

Fax

(989) 732-6577

NPI assigned

Mar 8, 2024

Last updated

Mar 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709856000000",
    "number": "1881452423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2782 S OTSEGO AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359404",
            "telephone_number": "989-732-7525",
            "fax_number": "989-732-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 S OTSEGO AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497359404",
            "telephone_number": "989-732-7525",
            "fax_number": "989-732-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKELEY",
        "first_name": "STACEY",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Gaylord, MI
• Providers in Gaylord, 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 Mar 8, 2024; 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.