Stacy Costopoulos Smith, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122299 Issued in CA

Practice address

3088 Pio Pico Dr Ste 203
Carlsbad, CA 92008-1965

Phone

(760) 494-4394

NPI assigned

May 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Stacy Costopoulos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 30, 2025 through Jan 30, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1495238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1174050124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3088 PIO PICO DR STE 203",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081965",
            "telephone_number": "760-494-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3088 PIO PICO DR STE 203",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920081965",
            "telephone_number": "760-494-4394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 W Mission Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920251721",
            "country_code": "US",
            "telephone_number": "760-747-3424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STACY",
        "middle_name": "COSTOPOULOS",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-20",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "COSTOPOULOS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Helen Smith, MS, CCC-SLP
• Madison Smith
• Reagan Nicole Smith
• Sareena Smith
• Shana Smith
• Steffanie Ann Smith
• Timothy Smith
• Amber Snider, MAPC, LPCC
• Ryan Ilysse Snodgrass, LMFT, LPCC
• Glenn Charles Snyders Jr., M.D.

• Marriage & Family Therapist in Carlsbad, CA
• Providers in Carlsbad, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.