Jerry Stovall, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS16319 Issued in CA

Practice address

2485 Old Eureka Way
Redding, CA 96001-0336

Phone

(530) 242-8971

Fax

(530) 244-1546

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982730438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 OLD EUREKA WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010336",
            "telephone_number": "530-242-8971",
            "fax_number": "530-244-1546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 OLD EUREKA WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010336",
            "telephone_number": "530-242-8971",
            "fax_number": "530-244-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVALL",
        "first_name": "JERRY",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS16319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CSW163190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon K. Stone, TFC PARENT
• W Kenneth Stone, M.D.
• Ryan Stotka, PHARM.D.
• Lisa D Stout, MFTI
• Helene Iris Stovall, LCSW
• Jolene K Stoxen
• Donald Richard Stradley Jr.
• Elli Strand, DMD
• Garret Strand, DPM
• Karen Christine Strand, MFTI

• Clinical Social Worker in Redding, CA
• Providers in Redding, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.