Farren A Stackhouse, PH.D., LCMHC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC009419 Issued in GA

Practice address

521 N Liberty St
Winston Salem, NC 27101-2949

Phone

(912) 223-2480

NPI assigned

Jul 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1215508536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 N LIBERTY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012949",
            "telephone_number": "912-223-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N LIBERTY ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012949",
            "telephone_number": "912-223-2480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8466 W Peoria Ave Ste 6",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853456548",
            "country_code": "US",
            "telephone_number": "602-507-7595",
            "fax_number": "602-429-8154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STACKHOUSE",
        "first_name": "FARREN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "15443",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John St.Angelo III
• Robin Susanne St.Clair, PA
• Carey Vastine Stabler, MD
• Richard Brandon Stacey, M.D.
• Jenna Stack, LCMHC-A, LCAS-A
• Warren D Stacks, MD
• Danielle Emily Stadler, PA-C
• Karyn Stagg, CRNA
• Lura W Stagg, M.D.
• Avril L Staley, BA, QP, CSAC-INTERN

• Professional Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.