Active NPI
Stacey J Davis, LCSW
- Social Worker
- Monticello, AR
National Provider Identifier
1962427443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1380C
- Practice address
- 790 Roberts Dr
Delta Counseling Assoc
Monticello, AR 71655 - Phone
- (870) 367-2461
- Fax
- (870) 367-1690
- NPI assigned
- Jul 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 1380C | AR | Primary |
Addresses
Primary practice location
790 Roberts Dr
Delta Counseling Assoc
Monticello, AR 71655
Mailing address
113 Gatesway Dr
Monticello, AR 71655
Phone (870) 723-5324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5U665 | Other | BLUE CROSS BLUE SHIELD |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1380C | AR | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delta Counseling Associates Inc | Past | 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.
-
- Community/Behavioral Health Agency
- Monticello, AR
- NPI 1053364612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962427443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 GATESWAY DR",
"city": "MONTICELLO",
"state": "AR",
"postal_code": "71655",
"telephone_number": "870-723-5324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 ROBERTS DR",
"address_2": "DELTA COUNSELING ASSOC",
"city": "MONTICELLO",
"state": "AR",
"postal_code": "71655",
"telephone_number": "870-367-2461",
"fax_number": "870-367-1690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "STACEY",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "1380C",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "5U665",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.