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Susan Michelle Stacy , C-PRSS

Peer Specialist β€’ Mcloud, OK

Active NPI 1124511639 Individual Practitioner Female Practitioner
Practice location in NPPES

105365 S Highway 102
Mcloud, OK 748513051

Call 4059882071 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

105365 S Highway 102

Mcloud, OK 748513051

Telephone 4059882071

NPI first issued

2018

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Mcloud and Oklahoma

7 active clinicians are listed under Peer Specialist with a practice address in Mcloud, OK (5,217 in Oklahoma).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-11-07
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

License # reported to NPPES OK 132075

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Social Worker

NUCC Taxonomy Code: 104100000X

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Peer Specialist

NUCC Taxonomy Code: 175T00000X

License # reported to NPPES OK 13205

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oklahoma State Board of Medical Licensure.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Amanda Garner

Physician Assistant - Medical

NPI 1255707535
Dr. Harbans Hans , MD

Psychiatry & Neurology - Psychiatry

NPI 1336362680

Doctor of Medicine (M.D.)

Amanda Quary , APRN-CNP

Nurse Practitioner - Family

NPI 1730552688

Advanced Practice Registered Nurse - Certified Nurse Practitioner

NPI 1851735658

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location November 07, 2022

Registered at 105365 S HIGHWAY 102, MCLOUD, OK 748513051 (Tel: 4059882071)

πŸ“
Updated Business Mailing Address November 07, 2022

Registered at 105365 S HIGHWAY 102, MCLOUD, OK 748513051 (Tel: 4059882071)

πŸ‘€
Provider Name / Credentials Updated November 07, 2022

Recorded as SUSAN STACY, C-PRSS

βœ…
NPI Profile Active June 08, 2018

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 08, 2018

Registered at 922 W HINCHLEY ST, MCLOUD, OK 748518032 (Tel: 9189467785)

πŸ“
Business Mailing Address (Initial Record) June 08, 2018

Registered at 922 W HINCHLEY ST, MCLOUD, OK 748518032 (Tel: 9189467785)

πŸ‘€
Provider Name / Credentials (Initial Record) June 08, 2018

Recorded as SUSAN ALEXANDER, LMSW

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2018

Social Worker

🟒
Initial NPI Registration & Enumeration June 08, 2018

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1124511639
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 08, 2018
Last Update: November 07, 2022
Sole Proprietor: No

Mailing Address

105365 S Highway 102

Mcloud, OK 748513051

Phone: 4059882071

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.