Stacey Anderson, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

101308 Issued in CA

Practice address

617 Veterans Blvd Ste 107
Redwood City, CA 94063-1404

Phone

(650) 716-8703

NPI assigned

Mar 13, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1265935530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 EDGEWOOD RD",
            "city": "EMERALD HILLS",
            "state": "CA",
            "postal_code": "940623222",
            "telephone_number": "650-716-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 VETERANS BLVD STE 107",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631404",
            "telephone_number": "650-716-8703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1937 Edgewood Rd",
            "address_purpose": "LOCATION",
            "city": "Emerald Hills",
            "state": "CA",
            "postal_code": "940623222",
            "country_code": "US",
            "telephone_number": "650-716-8703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STACEY",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "101308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.