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

Stacey Kay Mock

Individual provider Clinical Social Worker · NPI 1154901361

Stacey Kay Mock is a Clinical Social Worker in Russellville, Kentucky. Qualified in 2022, 4 years ago. Practices with Kw Consulting LLC, a 28-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
4
Licensed in
KY
In the registry since
2021
Specialties on file
2

Practice location Address checks out

433 Shelton Ln
Russellville, KY 42276-7600
Phone: (270) 901-5000
Show map & directions

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 260182 (KY)
Social Worker Taxonomy 104100000X

Record details

NPI number1154901361
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 12, 2021
Last updated in NPPESMarch 24, 2025
Certification dateMarch 24, 2025
Mailing address380 Suwannee Trail St, Bowling Green, KY 42103-7956

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Kw Consulting Llc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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