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MR. JOHN JOSEPH STACY MLTDSW, CAC-1
NPI 1912035627
Social Worker - Clinical in Ann Arbor, MI

Active since March 02, 2007PECOS EnrolledAccepts Medicare Assignment
2140 E ELLSWORTH RD, ANN ARBOR, MI 48108(734) 222-9501(734) 971-2487 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. John Joseph Stacy Mltdsw, Cac-1 NPPES

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

MR. JOHN JOSEPH STACY MLTDSW, CAC-1 (NPI 1912035627) is an individual clinical provider in Ann Arbor, Michigan, licensed in Michigan (6801087738) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1912035627
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. JOHN JOSEPH STACYCredential: MLTDSW, CAC-1
Location Address2140 E ELLSWORTH RDAnn Arbor, MI 48108-2552
Mailing Address555 Towner St, Po Box 915Ypsilanti, MI 48198-5752 · (734) 544-3000 · Fax (734) 544-6732
Phone(734) 222-9501
Fax(734) 971-2487
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateMarch 2, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1912035627 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 MI · 6801087738
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.
2140 E ELLSWORTH RD, Ann Arbor, MI 48108
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. John Joseph Stacy Mltdsw, Cac-1 is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820520901
PECOS Enrollment IDI20241014003646
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $58.04 – $177.36
Typical copayment $0.00 (range $14.51 – $44.34)
Most-billed visit code NA
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MIGUEL RODRIGUES
Community Health Worker
2140 E ELLSWORTH RD
ANN ARBOR, MI 48108
Washtenaw County (734) 544-3050
CHRISTINA BLACK
Community Health Worker
2140 E ELLSWORTH RD
ANN ARBOR, MI 48108
Washtenaw County (734) 544-3050
MYA M WATTS
Social Worker
2140 E ELLSWORTH RD
ANN ARBOR, MI 48108
Washtenaw County (734) 544-3050
LAURA C GOINS SWT
Social Worker
2140 E ELLSWORTH RD
ANN ARBOR, MI 48108
Washtenaw County (734) 222-3424
SUSAN ELIZABETH THOMPSON LLMSW
Social Worker
2140 E ELLSWORTH RD
ANN ARBOR, MI 48108
Washtenaw County (734) 496-0378
DR. ELLEN SMITH PERRICCI MD
Psychiatry & Neurology (Psychiatry)
2140 E ELLSWORTH RD
ANN ARBOR, MI 48108
Washtenaw County (734) 477-7417
MR. DANIEL ANTONY ING MA,LLP,CCHP
Psychologist
2140 E ELLSWORTH RD
ANN ARBOR, MI 48108
Washtenaw County (734) 222-3581
MR. CHRISTOPHER J SINGER LLMSW
Social Worker (Clinical)
2140 E ELLSWORTH RD
ANN ARBOR, MI 48108
Washtenaw County (734) 544-3000

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 John Stacy's NPI number?

The NPI number for John Stacy is 1912035627. It was assigned to this individual provider in the NPPES registry on March 2, 2007.

Where is John Stacy located?

John Stacy practices at 2140 E Ellsworth Rd, Ann Arbor, MI 48108. The listed phone number is (734) 222-9501.

What is John Stacy's specialty?

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

Is John Stacy enrolled in Medicare?

Yes. John Stacy is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for John Stacy was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.