Active NPI
Stacy J Bauman, M.S., LPC-INTERN
- Mental Health Counselor
- Richardson, TX
National Provider Identifier
1174871883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 66347
- Practice address
- 275 W Campbell Rd
Richardson, TX 75080-3601 - Phone
- (817) 939-6308
- NPI assigned
- Aug 28, 2012
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 66347 | TX | Primary |
Addresses
Primary practice location
275 W Campbell Rd
Richardson, TX 75080-3601
Mailing address
6725 Cambrian Way
Fort Worth, TX 76137-6603
Phone (817) 939-6308
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66347 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1174871883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6725 CAMBRIAN WAY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761376603",
"telephone_number": "817-939-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 W CAMPBELL RD",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750803601",
"telephone_number": "817-939-6308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMAN",
"first_name": "STACY",
"middle_name": "J",
"credential": "M.S., LPC-INTERN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-28",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "66347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.