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

Stacy M Wynn

Individual provider Clinical Social Worker · NPI 1891083549

Stacy M Wynn is a Clinical Social Worker in Capac, Michigan. Qualified in 2010, 16 years ago. Practices with Blue Water Mental Health Clinic, a 23-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
16
Licensed in
MI
In the registry since
2011

Practice location Address checks out

14960 E Park St
Capac, MI 48014-3177
Phone: (810) 395-4343
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 6801092800 (MI)

Record details

NPI number1891083549
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 15, 2011
Last updated in NPPESJuly 15, 2011
Mailing address4055 Aletha Ln, Port Huron, MI 48060-1769

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Blue Water Mental Health Clinic — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Capac