Stacy Haag, LPC/MHSP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3299 Issued in TN

Practice address

105 Otis Smith Dr
Clarksville, TN 37043-8940

Phone

(931) 320-9213

NPI assigned

Dec 19, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Stacy Fye Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15315/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Franklin, TN
  • NPI 1124756085
  Medicare reassignment Care Compare group NPD
• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288

  Mental Health

  NPD
• Mental Health Cooperative, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, TN
  • NPI 1083632897
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1104000769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 OTIS SMITH DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438940",
            "telephone_number": "931-320-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 OTIS SMITH DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438940",
            "telephone_number": "931-320-9213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAG",
        "first_name": "STACY",
        "name_prefix": "Ms.",
        "credential": "LPC/MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-19",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1407",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "3299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI STATE BOARD OF EXAMINERS FOR LICENSED PROFESSIONAL COUNSELORS",
            "identifier": "1407",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS DEPT OF MENTAL HEALTH",
            "identifier": "PH1444",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BOARD OF PROF. COUNSELORS AND MARTIAL AND FAMILY THERAPISTS LICENSED PASTORAL",
            "identifier": "3299",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY STATE BOARD OF PROF. COUNSELORS",
            "identifier": "290113",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "FYE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David L Gullett, M.D.
• Anne Marie Gunn, D.O.
• John C. Gunn, D.M.D.
• H3 Therapy
• Erin Haack
• Leah Haas, CCC-SLP
• David H Haase, MD
• Randall Robert Haase, M.D.
• John Edison Hackett, PT
• Melinda Haddock-Diaz, DNP, APRN, FNP-C

• Professional Counselor in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.