Individual provider Active NPI

Stephan McLaughlin, LCSW

  • Clinical Social Worker
  • Memphis, TN
National Provider Identifier
1962964395
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9450-C Issued in NV
Practice address
41 N East Yates Rd
Memphis, TN 38120-2065
Phone
(901) 870-8696
NPI assigned
Apr 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1362 WY
Clinical Social Worker 1041C0700X 12145054-3501 UT
Clinical Social Worker 1041C0700X 9450-C NV Primary
Social Worker 104100000X 11474 TN

Addresses

Primary practice location

41 N East Yates Rd
Memphis, TN 38120-2065

Mailing address

41 N East Yates Rd
Memphis, TN 38120-2065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211115002884 NV Practitioner - Clinical Social Worker 7012306913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9450-CNVMDClinical Social Worker
12145054-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vitality Unlimited CurrentSince Aug 7, 2021 Accepting new patients
Vitality Unlimited Current Accepting new patients

Locations

120 Pike St
Dayton, NV 89403
Phone (775) 241-9440

3740 E Idaho St
Elko, NV 89801
Phone (775) 738-8004

215 Bluffs Ave
Ste 200
Elko, NV 89801
Phone (775) 738-2925

1250 Lamoille Hwy
Ste 942
Elko, NV 89801
Phone (775) 738-0166

1135 Terminal Way
Ste 112
Reno, NV 89502
Phone (775) 322-3668

Organizations & group practices 2

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1962964395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 N EAST YATES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 N EAST YATES RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202065",
            "telephone_number": "901-870-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLAUGHLIN",
        "first_name": "STEPHAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-04",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "1362",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12145054-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9450-C",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "11474",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.