Active NPI
Stacey Nicole Alvia Brodie Walker
- Counseling Psychologist
- Plantation, FL
National Provider Identifier
1285106880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- PY8168
- Practice address
- 150 S Pine Island Rd Ste 300
Plantation, FL 33324-2665 - Phone
- (754) 801-9750
- NPI assigned
- Dec 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | PY8168 | FL | Primary |
Addresses
Primary practice location
150 S Pine Island Rd Ste 300
Plantation, FL 33324-2665
Mailing address
9916 Nob Hill LN
Sunrise, FL 33351-4665
Phone (754) 801-9750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY8168 | FL | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1285106880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9916 NOB HILL LN",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333514665",
"telephone_number": "754-801-9750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 S PINE ISLAND RD STE 300",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333242665",
"telephone_number": "754-801-9750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODIE WALKER",
"first_name": "STACEY",
"middle_name": "NICOLE ALVIA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-19",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "FL",
"license": "PY8168",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.