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STACY LYNN FAZIO LCSW
NPI 1104261544
Social Worker - Clinical in Clovis, CA

Active since April 29, 2013Opted out of Medicare · through Oct 1, 2026
755 N PEACH AVE STE H14, CLOVIS, CA 93611(555) 999-7308(559) 712-6282 Get Directions Write a Review

NPPES record last updated: August 28, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 28, 2022, Feb 17, 2021 (2 updates tracked since 2021).

About Stacy Lynn Fazio Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACY LYNN FAZIO LCSW (NPI 1104261544) is an individual clinical provider in Clovis, California, licensed in California (LCSW19354) and active in the NPI registry since April 2013. She has opted out of Medicare through October 1, 2026.

NPPES Registry Identity

NPI1104261544
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSTACY LYNN FAZIOCredential: LCSW
Location Address755 N PEACH AVE STE H14Clovis, CA 93611-7264
Mailing Address673 W Richmond AveClovis, CA 93619-4825 · (555) 999-7308 · Fax (559) 712-6282
Phone(555) 999-7308
Fax(559) 712-6282
Sole ProprietorYes
Enumeration DateApril 29, 2013
Last NPPES UpdateAugust 28, 20222 updates tracked since enumeration
NPPES CertifiedAugust 28, 2022
✔ NPI 1104261544 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · LCSW19354
Definition
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.
755 N PEACH AVE STE H14, Clovis, CA 93611
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Stacy Lynn Fazio Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2024 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2024
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacy Fazio's NPI number?

The NPI number for Stacy Fazio is 1104261544. It was assigned to this individual provider in the NPPES registry on April 29, 2013.

Where is Stacy Fazio located?

Stacy Fazio practices at 755 N Peach Ave Ste H14, Clovis, CA 93611. The listed phone number is (555) 999-7308.

What is Stacy Fazio's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Stacy Fazio enrolled in Medicare?

No. Stacy Fazio has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Stacy Fazio was last updated on August 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.