MS. STACEY TYWANNA HAILEY (NPI# 1083866628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083866628 |
| Entity Type | Individual |
| Full Name | MS. STACEY TYWANNA HAILEY |
| Practice Address |
139 Three Hunts Dr Pembroke NC 28372-6800 |
| Mailing Address |
7841 Walters Rd Laurel Hill NC 28351-8947 |
| Practice Telephone | 9102723220 |
| Mailing Telephone | 9102723220 |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2013-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
0904007617 | VA | Behavioral Health & Social Service Providers |
| Street Address |
139 THREE HUNTS DR |
| City | PEMBROKE |
| State | NC |
| Zip Code | 28372-6800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073828661 | Andrea L Chappell | Pharmacist | 139 Three Hunts Dr, Pembroke, NC 28372 | 2010-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962977 | Kayla J Oxendine | Counselor | 86 Threehunts Drive, Pembroke, NC 28372 | 2020-11-03 |
| 1720688401 | Melissa Claire Kratz | Pharmacist | 930 Hwy 711 East, Pembroke, NC 28372 | 2020-10-30 |
| 1841775681 | Nikki Locklear | Counselor | 86 Three Hunts Dr., Pembroke, NC 28372 | 2018-09-27 |
| 1043703218 | Julie Anne Harrison-swartz | Nurse Practitioner | Uncp Student Health, 113 Hawk Drive, Pembroke, NC 28372 | 2018-06-12 |
| 1134627508 | William Dixon | Specialist/Technologist | One University Drive, Pembroke, NC 28372 | 2018-01-31 |
| 1740796291 | A Primary Choice, Inc. | In Home Supportive Care | 208 Union Chapel Road, Suite D, Pembroke, NC 28372 | 2017-12-20 |
| 1578924130 | William Joshua Johnson | Nurse Practitioner | 3334 Moss Neck Road, Pembroke, NC 28372 | 2016-03-10 |
| 1831560234 | Sungjun Jung | Pharmacist | 930 Nc Hwy 711 E, Pembroke, NC 28372 | 2015-10-12 |
| 1154715027 | Lilly Marie Shorter | Counselor | 86 Three Hunt Drive, Pembroke, NC 28372 | 2015-03-27 |
| 1487046728 | Eye Heart You Home Health, LLC | Public Health or Welfare | 925 University Road, Pembroke, NC 28372 | 2015-02-24 |
| Find all providers in zip 28372 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790034593 | Mara D Hunt | Social Worker | 60 Commerce Plaza Cir, Pembroke, NC 28372-7386 | 2012-09-07 |
| 1770855389 | Ryan Shirilla | Social Worker | 447 Deerpath Ln, Pembroke, NH 03275-3214 | 2012-01-30 |
| 1558659680 | Rachel S Cohen | Social Worker | 20 Winter Street, Pembroke, MA 02359 | 2011-07-11 |
| 1790949907 | Tammy Rocha Cetrino | Social Worker | 125 Church St Ste 90-104, Pembroke, MA 02359-1929 | 2008-07-16 |
| 1275717084 | Elizabeth Zaccardi | Social Worker | 34 Mill St, Pembroke, MA 02359-3201 | 2007-12-28 |
| 1972710861 | Susan Michelle Wilson | Social Worker | 24 Champion Way, Pembroke, MA 02359-2637 | 2007-05-17 |
| 1871705939 | Recovery and Growth Counseling | Social Worker | 2 Columbia Road, Pembroke, MA 02360 | 2007-05-03 |
| 1912128463 | Mary A Marek | Social Worker | 2 Columibia Road, Pembroke, MA 02359 | 2007-05-01 |
| 1265577258 | Nicole Marie Macdonald | Social Worker | 122 Chapel St, Pembroke, MA 02359-3815 | 2007-02-20 |
| 1154431468 | Janice Elaine Howard | Social Worker | 2 Columbia Rd Ste 8, Pembroke, MA 02359-1842 | 2006-08-30 |
| Find all providers in PEMBROKE | ||||
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| 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.