Active NPI
Stacey J Shoemaker, LPCC
- Mental Health Counselor
- Cincinnati, OH
National Provider Identifier
1083689210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E-0003347
- Practice address
- 4440 Glen Este Withamsville Rd
Suite 100
Cincinnati, OH 45245-1318 - Phone
- (513) 354-5735
- Fax
- (513) 753-7930
- NPI assigned
- Feb 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E-0003347 | OH | Primary |
Addresses
Primary practice location
4440 Glen Este Withamsville Rd
Suite 100
Cincinnati, OH 45245-1318
Mailing address
4440 Glen Este Withamsville Rd
Suite 100
Cincinnati, OH 45245-1318
Phone (513) 354-5735
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01183 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-0003347 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1083689210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4440 GLEN ESTE WITHAMSVILLE RD",
"address_2": "SUITE 100",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452451318",
"telephone_number": "513-354-5735",
"fax_number": "513-753-7930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4440 GLEN ESTE WITHAMSVILLE RD",
"address_2": "SUITE 100",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452451318",
"telephone_number": "513-354-5735",
"fax_number": "513-753-7930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOEMAKER",
"first_name": "STACEY",
"middle_name": "J",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E-0003347",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01183",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.