Nicole Stavsky, SWT

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.2202584-TRNE Issued in OH

Practice address

4998 W Broad St Ste 104
Columbus, OH 43228-1647

Phone

(614) 804-9897

NPI assigned

Aug 24, 2022

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Freedom Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Columbus, OH
  • NPI 1760246581
  NPD (past)

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1922727858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 S ROOSEVELT AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432092948",
            "telephone_number": "201-693-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4998 W BROAD ST STE 104",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281647",
            "telephone_number": "614-804-9897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3140 E Broad St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432092066",
            "country_code": "US",
            "telephone_number": "614-754-8051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAVSKY",
        "first_name": "NICOLE",
        "credential": "SWT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2202584-TRNE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0245034",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "freedomrecovery.us",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4998 W Broad St Ste 104",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432281647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Staudt, RPH, PHARMD
• Linda Jill Staufenberg, R.N.
• Dylan Stauffer
• Kristen M Stauffer, CNP
• Timothy Stauffer, PC-CR
• Stay at Home Health Care LLC
• Jane Katherine Stead, LSW
• Steadfast in Home Care Services LLC
• Steadfast in Home Care Services LLC
• Steadfast Loving Homes

• Social Worker in Columbus, OH
• Providers in Columbus, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.