STACELYNNE MACK (NPI# 1720590516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720590516 |
Entity Type | Individual |
Full Name | STACELYNNE MACK |
Other Name | STACELYNNE WALLACE |
Credential | LMSW |
Practice Address |
30601 Crest Frst Farmington Hills MI 48331-1052 |
Mailing Address |
Po Box 47505 Oak Park MI 48237-5205 |
Practice Telephone | 2485064065 |
Mailing Telephone | 2485064065 |
Enumeration Date | 2017-11-02 |
Last Update Date | 2017-11-02 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1041S0200X |
Social Worker Specialization: School |
6801082564 | MI | Behavioral Health & Social Service Providers |
Street Address |
30601 CREST FRST |
City | FARMINGTON HILLS |
State | MI |
Zip Code | 48331-1052 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700352804 | Lori A Galicki | Occupational Therapist | 3405 W 12 Mile Rd. Suite 200, Farmington Hills, MI 48331 | 2018-10-17 |
1700372877 | Brooke Breann Reed | Speech-Language Pathologist | 34505 W 12 Mile Rd Ste 210, Farmington Hills, MI 48331 | 2018-07-02 |
1215473848 | Devon Caroline Welling | Advanced Practice Midwife | 31000 Country Bluff, Farmington Hills, MI 48331 | 2017-01-06 |
1780040246 | Pamela Moraa Obare | Nurse Practitioner | 36839 Greenspring St, Farmington Hills, MI 48331 | 2016-01-13 |
1427429844 | Counseling for The Brain, Body and Spirit, LLC | Community/Behavioral Health | 36510 Twelve Mile Rd, Farmington Hills, MI 48331 | 2015-10-12 |
1538548458 | Shavohn Rowser | Durable Medical Equipment & Medical Supplies | 38657 Lancaster Dr, Farmington Hills, MI 48331 | 2015-05-26 |
1851727697 | Sidney Lawrence Stone | Ophthalmology | 28853 Nottoway Drive, Farmington Hills, MI 48331 | 2013-09-25 |
1659621159 | Jacqueline Kiernan | Physical Therapist | 27240 Haggarty, Suite E15, Farmington Hills, MI 48331 | 2012-09-12 |
1770876476 | Elizabeth Anne Clancy | Counselor | 37875 12 Mile Rd, Farmington Hill, MI 48331 | 2011-05-27 |
1902197833 | Carla's Companionship & Care LLC | Home Health | 31145 Floralview Dr. S. #207, Farmington Hills, MI 48331 | 2011-04-26 |
Find all providers in zip 48331 |
Taxonomy Code | 1041S0200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Social Worker |
Specialization | School |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467891432 | Sheryl Anne Stumbaugh | Social Worker | 21289 Whitlock St, Farmington Hills, MI 48336-5179 | 2013-06-22 |
1396128237 | Sheena Annette Burgess | Social Worker | 27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5326 | 2015-07-08 |
1790973667 | Emily Jean Woodman | Social Worker | 23332 Orchard Lake Rd, Suite A, Farmington Hills, MI 48336-3280 | 2007-10-04 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356949390 | Livonia Public Schools School District | Social Worker | 8900 Newburgh Rd, Livonia, MI 48150-3425 | 2020-10-13 |
1336756253 | Michael Holtzman | Social Worker | 3008 Brockman Blvd, Ann Arbor, MI 48104-4717 | 2020-09-24 |
1023626488 | Foadeh Ali Yahya | Social Worker | 5133 Saint Lawrence St Apt 2, Detroit, MI 48210-2162 | 2020-07-21 |
1427682277 | Kaylyn Marie Hoy | Social Worker | 131 Fairview St, Hanover, MI 49241-9702 | 2020-03-02 |
1972152569 | Alcona Citizens for Health, Inc. | Social Worker | 375 Wilson St Rm 12a, Alpena, MI 49707-1423 | 2019-09-06 |
1568010288 | Alcona Citizens for Health, Inc. | Social Worker | 7667 Us Highway 23 N Rm 111, Alpena, MI 49707-7905 | 2019-08-27 |
1962050690 | Alcona Citizens for Health, Inc. | Social Worker | 12170 Us Highway 23 S Rm 205b, Ossineke, MI 49766-9776 | 2019-08-27 |
1104383215 | Tara Horton | Social Worker | 8216 S 35 Rd, Cadillac, MI 49601-8958 | 2019-02-25 |
1649753146 | Family Medical Center of Michigan,inc | Social Worker | 13000 Essex Ave Rm 211, Detroit, MI 48215-3243 | 2018-09-11 |
1942780077 | Jodi Lynn Huizinga | Social Worker | 356 1/2 N Main, Cedar Springs, MI 49319-9776 | 2018-08-17 |
Find all providers with the same taxonomy |
City | FARMINGTON HILLS |
Zip Code | 48331 |
Please comment or provide details below to improve the information on STACELYNNE MACK.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.