Active NPI
Stephanie Ann Poole, LCSW
- Clinical Social Worker
- Glen Allen, VA
National Provider Identifier
1972934859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904008452
- Practice address
- 13100 Mountain Rd
Glen Allen, VA 23059-1734 - Phone
- (804) 512-8409
- NPI assigned
- Dec 3, 2013
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | ASW61665 | CA | |
| Clinical Social Worker | 1041C0700X | ASW 61665 | CA | |
| Clinical Social Worker | 1041C0700X | 0904008452 | VA | Primary |
Addresses
Primary practice location
13100 Mountain Rd
Glen Allen, VA 23059-1734
Mailing address
13100 Mountain Road
Glen Allen, VA 23059
Phone (804) 512-8409
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 |
|---|---|---|---|
| ASW61665 | CA | MD | Mental Health Counselor |
| ASW 61665 | CA | MD | Clinical Social Worker |
| 0904008452 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705536000000",
"number": "1972934859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13100 MOUNTAIN ROAD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "23059",
"telephone_number": "804-512-8409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13100 MOUNTAIN RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230591734",
"telephone_number": "804-512-8409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOLE",
"first_name": "STEPHANIE",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-03",
"last_updated": "2024-01-18",
"certification_date": "2024-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW61665",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW 61665",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904008452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Allen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.