Active NPI
Stacy Mae Sutherland, M.ED
- Professional Counselor
- Denton, TX
National Provider Identifier
1093002990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 66834
- Practice address
- 1403 Greenwood Dr
Denton, TX 76209-2206 - Phone
- (940) 765-6487
- NPI assigned
- Jun 30, 2011
- Last updated
- Dec 5, 2023
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 66834 | TX | Primary |
Addresses
Primary practice location
1403 Greenwood Dr
Denton, TX 76209-2206
Mailing address
2404 Fowler Dr
Denton, TX 76209-1919
Phone (574) 870-0332
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66834 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1093002990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2404 FOWLER DR",
"city": "DENTON",
"state": "TX",
"postal_code": "762091919",
"telephone_number": "574-870-0332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1403 GREENWOOD DR",
"city": "DENTON",
"state": "TX",
"postal_code": "762092206",
"telephone_number": "940-765-6487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTHERLAND",
"first_name": "STACY",
"middle_name": "MAE",
"credential": "M.ED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-30",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "66834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
- Surgery Associates of North Texas P a
- Surgery Associates of NTX, PLLC
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- Susan Karpiel Nutrition, LLC
- Susan Nichols Hostetter M D P a (Denton Radiology)
- Laura Kay Sutton, M.S.
- Suzanne E Mack, M.D., P.a. (North Texas Institute for Functional Medicine)
- Laura Michele Swartwood
- Christopher George Swayden, DMD
- Demetria Renae Sweatt-Phillips, COTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.