Individual provider Active NPI

Stacy Pineda, LAMFT

  • Marriage & Family Therapist
  • Meridian, ID
National Provider Identifier
1356989099
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LAMFT-8410 Issued in ID
Practice address
750 W Ustick Rd Ste 120
Meridian, ID 83646-6133
Phone
(208) 366-1678
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X LAMFT-8410 ID Primary

Addresses

Primary practice location

750 W Ustick Rd Ste 120
Meridian, ID 83646-6133

Mailing address

750 W Ustick Rd Ste 120
Meridian, ID 83646-6133
Phone (208) 366-1678

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

LicenseStateTypeSpecialty
LAMFT-8410IDMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1356989099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W USTICK RD STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466133",
            "telephone_number": "208-366-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W USTICK RD STE 120",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466133",
            "telephone_number": "208-366-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA",
        "first_name": "STACY",
        "name_prefix": "Mrs.",
        "credential": "LAMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "LAMFT-8410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.