Stacey Glenn Stocking, CMHC, ASUDC, TRS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

108034-6004 Issued in UT

Practice address

375 Rainbow LN
Midway, UT 84049-7001

Phone

(435) 654-1082

Fax

(435) 654-1482

NPI assigned

Aug 25, 2023

Last updated

Aug 25, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1225813637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 S DAVIS BLVD",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840102016",
            "telephone_number": "801-231-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 RAINBOW LN",
            "city": "MIDWAY",
            "state": "UT",
            "postal_code": "840497001",
            "telephone_number": "435-654-1082",
            "fax_number": "435-654-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKING",
        "first_name": "STACEY",
        "middle_name": "GLENN",
        "name_prefix": "Mr.",
        "credential": "CMHC, ASUDC, TRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "108034-6008",
            "primary": false
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "UT",
            "license": "108034-4002",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "108034-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Midway, UT
• Providers in Midway, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.