Individual provider Active NPI

Stacey Denise Guthrie, LPC-S

  • Professional Counselor
  • Olive Branch, MS
National Provider Identifier
1124477955
Registry record updated Dec 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1239 Issued in MS
Practice address
9761 Dorothy Dr
Olive Branch, MS 38654-6598
Phone
(901) 412-2720
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1239 MS Primary
School Counselor 101YS0200X 1239 MS
Mental Health Counselor 101YM0800X 1239 MS

Addresses

Primary practice location

9761 Dorothy Dr
Olive Branch, MS 38654-6598

Mailing address

8626 Airways Blvd
Southaven, MS 38671-2603
Phone (662) 772-5937

Other practice location 1

8626 Airways Blvd
Southaven, MS 38671-2603
Phone (662) 772-5937

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

LicenseStateTypeSpecialty
1239MSMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto Family Counseling Center PLLC Mental Health CurrentSince Dec 7, 2025 Accepting new patients
Play Fabulous Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764979200000",
    "number": "1124477955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8626 AIRWAYS BLVD",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386712603",
            "telephone_number": "662-772-5937",
            "fax_number": "662-772-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9761 DOROTHY DR",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386546598",
            "telephone_number": "901-412-2720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8626 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386712603",
            "country_code": "US",
            "telephone_number": "662-772-5937",
            "fax_number": "662-772-5940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTHRIE",
        "first_name": "STACEY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2025-12-06",
        "certification_date": "2025-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1239",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MS",
            "license": "1239",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "1239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.