Stacy L Fahlsing, DR.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

5830 Issued in OH

Practice address

3745 Shawnee Rd Ste 105
Lima, OH 45806-1662

Phone

(419) 999-2024

NPI assigned

Dec 25, 2006

Last updated

Nov 19, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dakota Professional CorpGroup PAC ID 6800810904, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Dakota Professional Corp

  dba Professional Psychological Associates

  • Clinical Psychologist
  • Lima, OH
  • NPI 1083667828
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1167004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1457416158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 S DIXIE HWY",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458043750",
            "telephone_number": "419-999-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 SHAWNEE RD STE 105",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458061662",
            "telephone_number": "419-999-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHLSING",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "DR.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-25",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eye Site of Lima
• Eye Surgery Center of Western Ohio LLC (Eye Surgery Center of Western Ohio)
• Nonso Andrew Ezema, M.D.
• Stanley Eziukwu, MD
• Kristy Ellen Faddis
• Stephanie Marie Fall, RN
• Family Chiropractic Care Center, Inc (Gillis Chiropractic Clinic)
• Family Medical Center of Lima, Inc.
• Family Physicians of Lima Inc
• Family Resource Center

• Psychologist in Lima, OH
• Providers in Lima, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.