Brendan Stack, LPC, LADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4530 Issued in CT

Practice address

519 Heritage Rd Ste 2A5
Southbury, CT 06488-6694

Phone

(518) 610-4528

NPI assigned

Feb 20, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southbury Adolescent and Young Adult Counseling CenterGroup PAC ID 5193221349, 15 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Southbury Adolescent and Young Adult Counseling Center

  • Mental Health Counselor
  • Southbury, CT
  • NPI 1235737735

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1316403892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 WATERTOWN RD",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621502",
            "telephone_number": "518-610-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 HERITAGE RD STE 2A5",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064886694",
            "telephone_number": "518-610-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "BRENDAN",
        "name_prefix": "Mr.",
        "credential": "LPC, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-20",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "001323",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "4530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Speech Works, LLC
• Speedrain Enterprises LLC
• Catherine Stillman Sperry, MSN RN
• Kaitlyn Moskey Spivey
• Alison Stack
• Terri Lynn Stanco, LCSW
• State of Connecticut
• State of Connecticut
• State of Connecticut
• State of CT, - Office of the Comptroller

• Professional Counselor in Southbury, CT
• Providers in Southbury, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.