Stacy Ann Bartholomew, LCSW
Social Worker, Clinical in Port Jefferson, NY. Individual provider (NPI-1).
NPI number1376466748
StatusActive
Last updated in NPPESAug 3, 2026
Details
- NPI
- 1376466748
- Entity type
- Individual (NPI-1)
- Name
- Ms. Stacy Ann Bartholomew
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 3, 2026
- Certification date
- Aug 3, 2026
- Last updated
- Aug 3, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 103122 | NY | Yes |
Practice location
1227 Main StPort Jefferson, NY 11777-2227
Phone 631-985-0903
Mailing address
5 Blackberry LnCenter Moriches, NY 11934-1412
Phone 631-697-8204
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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