Individual provider Active NPI

Stacey Ann Bastien, LMHC

  • Mental Health Counselor
  • Rochester, NY
National Provider Identifier
1255177754
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
014904-01 Issued in NY
Practice address
339 East Ave Ste 303
Rochester, NY 14604-2615
Phone
(585) 434-2633
Fax
(585) 434-2635
NPI assigned
Jul 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 014904-01 NY Primary

Addresses

Primary practice location

339 East Ave Ste 303
Rochester, NY 14604-2615

Mailing address

339 East Ave Ste 303
Rochester, NY 14604-2615
Phone (585) 434-2633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241029002833 NY Practitioner - Mental Health Counselor 5597298554 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014904-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC CurrentSince Oct 23, 2024 Accepting new patients
Knapp Street Psychiatry, PC CurrentSince Oct 23, 2024 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

300 Cadman Plz W
Fl 12
Brooklyn Heights, NY 11201
Phone (212) 439-7955

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

100 Park Ave
Fl 16
New York, NY 10017
Phone (212) 433-2384

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1255177754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 EAST AVE STE 303",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146042615",
            "telephone_number": "585-434-2633",
            "fax_number": "585-434-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 EAST AVE STE 303",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146042615",
            "telephone_number": "585-434-2633",
            "fax_number": "585-434-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIEN",
        "first_name": "STACEY",
        "middle_name": "ANN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014904-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.