Stacy Marie Young

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401016096 Issued in MI

Practice address

32652 Kno Drive
Dowagiac, MI 49047

Phone

(269) 982-3832

NPI assigned

Jun 9, 2017

Last updated

Nov 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Stacy Butler Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pokagon Band of Potawatomi Indians

  dba Pokagon Health Service

  • Federally Qualified Health Center (FQHC)
  • Dowagiac, MI
  • NPI 1497833271

  TX

  Medicare reassignment NPD
• Donarski Center for Mental Health Counseling

  • Mental Health Counselor
  • Saint Joseph, MI
  • NPI 1467113449
  NPD (past)
• Family Therapy & Development Centers Inc

  • Mental Health Counselor
  • Saint Joseph, MI
  • NPI 1295916187
  NPD (past)

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1295264448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67160 DAILEY RD",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491129660",
            "telephone_number": "269-845-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32652 KNO DRIVE",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "49047",
            "telephone_number": "269-982-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "STACY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401016096",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401016096",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006741",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "BUTLER",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Janelle Wolske, NP-C
• Workshop Therapy Services, LLC
• Kristen Wright, MD
• Joo-Youn Yi, D.D.S.
• David Wayne Young, M.D., M.S.
• Adeel Yousaf, M.D
• Cynthia Zachary, RDH
• Mohammad S Zaman, MD
• Kristine Michele Zelmer, RDH

• Counselor in Dowagiac, MI
• Providers in Dowagiac, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.