Active NPI
Stacey Van Eck, M.ED., ED.S.
- School Psychologist
- Elkhart, IN
National Provider Identifier
1164242590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- Practice address
- 2720 California Rd
Elkhart, IN 46514-1220 - Phone
- (574) 262-5542
- NPI assigned
- Oct 11, 2024
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Primary |
Addresses
Primary practice location
2720 California Rd
Elkhart, IN 46514-1220
Mailing address
3829 Fox Crossing Dr
Saint Joseph, MI 49085-9150
Phone (269) 718-9198
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elkhart Community Schools | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Elkhart, IN
- NPI 1922132307
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1164242590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3829 FOX CROSSING DR",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490859150",
"telephone_number": "269-718-9198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2720 CALIFORNIA RD",
"city": "ELKHART",
"state": "IN",
"postal_code": "465141220",
"telephone_number": "574-262-5542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN ECK",
"first_name": "STACEY",
"credential": "M.ED., ED.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-11",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.