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

MS. Theresa Dawn Stack, LMSW

Individual provider Clinical Social Worker · NPI 1427251909

MS. Theresa Dawn Stack, LMSW is a Clinical Social Worker in Traverse City, Michigan. Qualified in 1997, 29 years ago. Practices with Old Town Psychological Services, an 8-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
29
Licensed in
MI
In the registry since
2007
What do these letters mean?
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

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Practice location Address checks out

512 S Union St
Traverse City, MI 49684-3247 Not confirmed with CMS for 19 years — call before visiting
Phone: (231) 941-6550
Fax: (231) 941-8981
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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 6801019505 (MI)

Record details

NPI number1427251909
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMSW
Sole proprietorYes
NPI enumeratedJune 11, 2007
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Old Town Psychological Services — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Traverse City