Organization Active NPI

Stacey L. Donahue, LCSW, PLLC

  • Mental Health Counselor
  • Williamsville, NY
National Provider Identifier
1114394020
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
056508 Issued in NY
Legal business name
STACEY L. DONAHUE, LCSW, PLLC
Practice address
5500 Main St
Suite 209
Williamsville, NY 14221-6755
Phone
(716) 308-2443
Fax
(716) 632-0031
NPI assigned
Aug 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Authorized official

Name
Mrs. Stacey Lynn Donahue, LCSWNPI 1437347374
Title
Member
Phone
(716) 308-2443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 056508 NY Primary

Addresses

Primary practice location

5500 Main St
Suite 209
Williamsville, NY 14221-6755

Mailing address

5500 Main St
209
Williamsville, NY 14221-6755
Phone (716) 308-2443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151109000198 NY Part B Supplier - Clinic/Group Practice 9537479274 Receives reassigned benefits from 1 practitioner
Practice locations: Williamsville, NY

National Provider Directory

National Provider Directory

Locations

5500 Main St
Ste 209
Williamsville, NY 14221
Phone (401) 431-2953

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1114394020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST",
            "address_2": "209",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216755",
            "telephone_number": "716-308-2443",
            "fax_number": "716-632-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MAIN ST",
            "address_2": "SUITE 209",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216755",
            "telephone_number": "716-308-2443",
            "fax_number": "716-632-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY L. DONAHUE, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "DONAHUE",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "716-308-2443",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "056508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.