MEDICARE: MS. STACEY MARIE FUTCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1205072576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STACEY MARIE FUTCH

Provider Business Mailing Address
First Line	:	13516 GREENCASTLE RIDGE TER
Second Line	:	APT 401
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-2129
Country	:	US
Telephone Number	:	301-520-7382
Fax Number	:

Provider Business Practice Location Address
First Line	:	13516 GREENCASTLE RIDGE TER
Second Line	:	APT 401
City	:	BURTONSVILLE
State	:	MD
Zip	:	20866-2129
Country	:	US
Telephone Number	:	301-520-7382
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2008
Last Update Date	:	05/10/2026

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