STACY DAVIDSON – Social Worker, NPI 1902570500

STACY DAVIDSON is a healthcare provider. based in Boston, Massachusetts. specializing in CLINICAL SOCIAL WORKER. They hold a License No. LICSW114032 (MA). The NPI Number for STACY DAVIDSON is 1902570500

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
STACY DAVIDSON
NPI
1902570500
Phone
(617) 371-3000
Address
66 CANAL ST
Enumeration Date
6 August 2021
Last Update Date
19 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
3375032949
Group Practice PAC ID
6103921184
Professional Enrollment ID
I20251103001270
Address ID
MA021142002BO66XXXSTXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

4,194 CLINICAL SOCIAL WORKER in MA

Provider Addresses for STACY DAVIDSON

  • 66 CANAL ST

    BOSTON, MA 021142002

    Phone: (617) 371-3000

    Type: Location

  • 151 EVERETT AVE

    CHELSEA, MA 021501807

    Phone: (802) 274-1771

    Type: Location

  • 47 OCEAN ST # 2R

    LYNN, MA 019022024

    Phone: (802) 274-1771

    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: 2025-11-03

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
I20251103001270IClinical Social WorkerMATBD

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 02114)

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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: 6103921184View full group profile
NameSpecialtyState
Clinical Social WorkerMA
Nurse PractitionerMA
P S Y C H I A T R YMA
Mental Health CounselorMA

Reviews

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Frequently asked questions

What number should I use to identify STACY DAVIDSON for billing?
Administrative and clinical systems typically use NPI 1902570500 for STACY DAVIDSON.
Should I treat STACY DAVIDSON as an active provider?
Patients and plans typically see STACY DAVIDSON as active in the national extract.
What type of care does STACY DAVIDSON provide?
STACY DAVIDSON's profile centers on Social Worker. Clinical services aligned with this taxonomy classification.
Can patients visit STACY DAVIDSON in Boston, Massachusetts?
For routing, start with Boston, Massachusetts for STACY DAVIDSON, then verify phone and hours locally.
Can I export STACY DAVIDSON's record?
You can download the official NPPES record; we summarize key fields for readability.

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