Active NPI
Stacie Eliopulos, MSW
- Clinical Social Worker
- Reno, NV
National Provider Identifier
1962805259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CG60566954
- Practice address
- 280 Vista Knoll Pkwy Ste 107
Reno, NV 89506-5649 - Phone
- (775) 250-0607
- NPI assigned
- Oct 1, 2014
- Last updated
- Jan 9, 2020
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CG60566954 | WA | Primary |
Addresses
Primary practice location
280 Vista Knoll Pkwy Ste 107
Reno, NV 89506-5649
Mailing address
280 Vista Knoll Pkwy Ste 107
Reno, NV 89506-5649
Phone (775) 250-0607
Other practice location 1
1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200 ext. 2882
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
| License | State | Type | Specialty |
|---|---|---|---|
| CG60566954 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578528000000",
"number": "1962805259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 VISTA KNOLL PKWY STE 107",
"city": "RENO",
"state": "NV",
"postal_code": "895065649",
"telephone_number": "775-250-0607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 VISTA KNOLL PKWY STE 107",
"city": "RENO",
"state": "NV",
"postal_code": "895065649",
"telephone_number": "775-250-0607"
}
],
"practiceLocations": [
{
"address_1": "1600 E Olive St",
"address_2": "Sound Mental Health",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981222735",
"country_code": "US",
"telephone_number": "206-302-2200 x2882",
"fax_number": "206-302-2210",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELIOPULOS",
"first_name": "STACIE",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-01",
"last_updated": "2020-01-09",
"certification_date": "2020-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "CG60566954",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.