Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Theresa Dawn Stack, LMSW

Individual provider Clinical Social Worker · NPI 1427251909

MS. Theresa Dawn Stack, LMSW is a Clinical Social Worker in Traverse City, Michigan. Qualified in 1997, 29 years ago. Practices with Old Town Psychological Services, an 8-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
29
Licensed in
MI
In the registry since
2007
What do these letters mean?
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

512 S Union St
Traverse City, MI 49684-3247
Phone: (231) 941-6550
Fax: (231) 941-8981
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801019505 (MI)

Record details

NPI number1427251909
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMSW
Sole proprietorYes
NPI enumeratedJune 11, 2007
Last updated in NPPESJuly 8, 2007
Mailing address512 S Union St, Traverse City, MI 49684-3247

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Old Town Psychological Services — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Traverse City