Active NPI
Stacy Seitz, LCPC
- Professional Counselor
- Alton, IL
National Provider Identifier
1104208495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180.011362
- Practice address
- 2615 Edwards St
Alton, IL 62002-3915 - Phone
- (618) 462-2331
- Fax
- (618) 462-2504
- NPI assigned
- Jun 23, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | 180.011362 | IL | Primary |
Addresses
Primary practice location
2615 Edwards St
Alton, IL 62002-3915
Mailing address
902 W Main St
West Frankfort, IL 62896-2210
Phone (618) 937-6483
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 |
|---|---|---|---|
| 180.011362 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1104208495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 W MAIN ST",
"city": "WEST FRANKFORT",
"state": "IL",
"postal_code": "628962210",
"telephone_number": "618-937-6483",
"fax_number": "618-462-2504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 EDWARDS ST",
"city": "ALTON",
"state": "IL",
"postal_code": "620023915",
"telephone_number": "618-462-2331",
"fax_number": "618-462-2504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEITZ",
"first_name": "STACY",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-23",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"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": "IL",
"license": "180.011362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.