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

Stanley Thomas Antonelli III, LCSW, LCAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1720328446

Stanley Thomas Antonelli III, LCSW, LCAC is a Clinical Social Worker in Kokomo, Indiana. Qualified in 2005, 21 years ago. Practices with Psychotherapy Associates of Kokomo, LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
21
Licensed in
IN
In the registry since
2013
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

4004 Pleasant Dr
Kokomo, IN 46902-5858
Phone: (574) 727-1833
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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 34005677A (IN)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 87001442A (IN)
School Social Worker Taxonomy 1041S0200X · Licence 1619240 (IN)

Record details

NPI number1720328446
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW , LCAC
Sole proprietorNo
NPI enumeratedFebruary 15, 2013
Last updated in NPPESFebruary 15, 2013

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Psychotherapy Associates Of Kokomo, Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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