Debra Stacey, MSNE PMHNP ANP CDE

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

401660 Issued in NY

Practice address

5820 Main St Ste 406
Williamsville, NY 14221-5734

Phone

(716) 544-0996

Fax

(716) 544-0997

NPI assigned

Jun 25, 2010

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

Other names 1

• Debra Madison Former name

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481414400000",
    "number": "1275844136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3843 UNION RD # 15-127",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142254256",
            "telephone_number": "716-544-0996",
            "fax_number": "716-544-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 MAIN ST STE 406",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215734",
            "telephone_number": "716-544-0996",
            "fax_number": "716-544-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "DEBRA",
        "credential": "MSNE PMHNP ANP CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2016-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "486617-1",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "MADISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Stephen St Marie, MD
• Betty St. Clair, LPN
• Chelsea M St. Laurent, LMHC
• Sarah G Stabler, LMT, NCTMB
• Stacey L. Donahue, LCSW, PLLC
• Catherine C Stack, CNM
• Shane Michael Stadtmueller, DC, MS, ATC
• Kerri Ann Staffeldt, RPH
• Taylor Stahl, RN
• Renay Staley, LPN

• Psychiatric/Mental Health Nurse Practitioner in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2016; 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.