Individual provider Active NPI

Stacy Jo Poffenbarger, CAP

  • Mental Health Counselor
  • West Palm Beach, FL
National Provider Identifier
1336547546
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH23273 Issued in FL
Practice address
726 Selkirk St
West Palm Beach, FL 33405-3136
Phone
(561) 398-7294
NPI assigned
Dec 22, 2014
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6063 FL
Mental Health Counselor 101YM0800X MH23273 FL Primary

Addresses

Primary practice location

726 Selkirk St
West Palm Beach, FL 33405-3136

Mailing address

726 Selkirk Street
West Palm Beach, FL 33405
Phone (561) 398-7294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20251107003913 FL Practitioner - Mental Health Counselor 2365932233 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1991 Pershing Ave
North Bellmore, NY 11710-1526

615 Crescent Executive CT
Suite 100
Lake Mary, FL 32746-2118

66 E Flagler St
Miami, FL 33130-1807

PO Box
Suite 830525
Birmingham, AL 35283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6063FLMDAddiction (Substance Use Disorder) Counselor
MH23273FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Sep 30, 2025 Accepting new patients
Quality BHS Florida, LLC CurrentSince Nov 1, 2025 Accepting new patients
Telos Health Systems FL LLC Mental Health CurrentSince Nov 3, 2025 Accepting new patients

Locations

4250 66th St N
Kenneth City, FL 33709
Phone (350) 250-2435

5860 W Junior College Rd
Key West, FL 33040
Phone (305) 293-1299

615 Crescent Executive Ct
Ste 100
Lake Mary, FL 32746
Phone (201) 217-6777

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1501 SE 24th Rd
Ocala, FL 34471
Phone (352) 257-7777

100 S Ashley Dr
Ste 600
Tampa, FL 33602
Phone (813) 766-4218

2180 10th Ave
Vero Beach, FL 32960
Phone (772) 564-9511

980 Sylvan Ave
Englewood Cliffs, NJ 07632
Phone (201) 217-6777

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1336547546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 SELKIRK STREET",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33405",
            "telephone_number": "561-398-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 SELKIRK ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334053136",
            "telephone_number": "561-398-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POFFENBARGER",
        "first_name": "STACY JO",
        "credential": "CAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-22",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "6063",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH23273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.