Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. John Joseph Stacy, MLTDSW, CAC-1

Individual provider Clinical Social Worker · NPI 1912035627

Mr. John Joseph Stacy, MLTDSW, CAC-1 is a Clinical Social Worker in Ann Arbor, Michigan. Qualified in 2006, 20 years ago. Practices with State of Ohio Office of Budget and Management State Accounting, a 109-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
20
Licensed in
MI
In the registry since
2007
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Practice location Address checks out

2140 E Ellsworth Rd
Ann Arbor, MI 48108-2552
Phone: (734) 222-9501
Fax: (734) 971-2487
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801087738 (MI)

Record details

NPI number1912035627
Entity typeIndividual (Type 1)
GenderMale
Credentials MLTDSW , CAC-1
Sole proprietorNo
NPI enumeratedMarch 2, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice State Of Ohio Office Of Budget And Management State Accounting — 109 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Ann Arbor