BONNIE STANFORD – Counselor, NPI 1679016455

BONNIE STANFORD is a healthcare provider. based in South daytona, Florida. specializing in CLINICAL SOCIAL WORKER. The NPI Number for BONNIE STANFORD is 1679016455

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
BONNIE STANFORD
NPI
1679016455
Phone
(386) 304-7600
Address
2400 S RIDGEWOOD AVE
Enumeration Date
28 November 2016
Last Update Date
28 November 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2076161127
Graduation Year
2003 (23 years ago)
PAC ID
5193203073
Group Practice PAC ID
0840729562
Professional Enrollment ID
I20260202001141
Address ID
ME041036005PO222XXSTXX302
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:9State licenses:0Digital endpointsOther names

3,374 CLINICAL SOCIAL WORKER in FL

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Provider Addresses for BONNIE STANFORD

  • 2400, Ridgewood Avenue, South Daytona, Volusia County, Florida, 32119, United States

    SOUTH DAYTONA, FL 321193097

    Phone: (386) 304-7600

    Type: Location

  • 918, 3rd Street, Port Orange, Volusia County, Florida, 32129, United States

    PORT ORANGE, FL 321293206

    Phone: (850) 443-6843

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-02-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260202001141IClinical Social WorkerMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32119)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840729562View full group profile
NameSpecialtyState
Mental Health CounselorME
Mental Health CounselorFL
Mental Health CounselorFL
Clinical Social WorkerRI
Clinical Social WorkerRI
Nurse PractitionerME
Nurse PractitionerME
Clinical Social WorkerTX
Nurse PractitionerME
Clinical Social WorkerRI

Reviews

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Frequently asked questions

What is the standard ID for BONNIE STANFORD in the U.S.?
In the U.S., BONNIE STANFORD is identified by NPI 1679016455.
Is BONNIE STANFORD currently accepting referrals based on NPI status?
Registry metadata lists BONNIE STANFORD as active.
What type of care does BONNIE STANFORD provide?
BONNIE STANFORD's profile centers on Counselor. Clinical services aligned with this taxonomy classification.
Which community is linked to BONNIE STANFORD?
BONNIE STANFORD shows a connection to South Daytona, Florida in registry-derived data.
Who maintains BONNIE STANFORD's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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