Individual provider Active NPI

Gary A Stauffer, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1942649942
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
680100886 Issued in MI
Practice address
4925 Packard St
Suite 16
Ann Arbor, MI 48108-1521
Phone
(734) 971-9781
NPI assigned
Jun 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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 680100886 MI Primary

Addresses

Primary practice location

4925 Packard St
Suite 16
Ann Arbor, MI 48108-1521

Mailing address

4925 Packard St
Suite 16
Ann Arbor, MI 48108-1521
Phone (734) 971-9781

Other identifiers 1

IdentifierTypeStateIssuer
16799687339MedicaidMI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
680100886MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of Michigan Incorporated PastSince Jun 1, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1942649942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "address_2": "SUITE 16",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "address_2": "SUITE 16",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUFFER",
        "first_name": "GARY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "680100886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16799687339",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.