NPIMap

Individual provider Active NPI

Stacy Lovell Slocum I, APCC

  • Mental Health Counselor
  • Fresno, CA
National Provider Identifier
1477096725
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1027 N Van Ness Ave
Fresno, CA 93728-3429
Phone
(559) 268-7613
NPI assigned
Nov 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Psychiatric Technician 167G00000X PT 34689 CA
Mental Health Counselor 101YM0800X CA Primary

Addresses

Primary practice location

1027 N Van Ness Ave
Fresno, CA 93728-3429

Mailing address

2733 E Rockingham CT
Fresno, CA 93720-5340
Phone (559) 573-4863

Other practice location 1

7120 N Marks Ave Ste 110
Fresno, CA 93711-0268
Phone (559) 439-5437

Other practice location 2

10120 Lanes Bridge Dr
Madera, CA 93636-8890
Phone (559) 431-5532

Other practice location 3

4291 N Millbrook Ave
Fresno, CA 93726-3438
Phone (559) 224-7967

Other practice location 4

718 E Minarets Ave
Fresno, CA 93720-3010
Phone (559) 447-1117

Other practice location 5

1853 E Niles Ave
Fresno, CA 93720-2342
Phone (559) 325-3892

Other practice location 6

1942 E Niles Ave
Fresno, CA 93720-2344
Phone (559) 323-4957

Other practice location 7

775 E Spruce Ave
Fresno, CA 93720-3016
Phone (559) 431-5073

Other practice location 8

4974 N Fresno st
654
Fresno, CA 93726
Phone (559) 826-6281

Other practice location 9

1415 W Barstow Ave
Fresno, CA 93711-3018
Phone (559) 438-9344

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
PT 34689CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Promesa Behavioral Health Past Accepting new patients
Genesis Family Center Past Accepting new patients
Promesa Behavioral Health PastSince Nov 15, 2020 Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients
Promesa Behavioral Health Past Accepting new patients

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1477096725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 E ROCKINGHAM CT",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937205340",
            "telephone_number": "559-573-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 N VAN NESS AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937283429",
            "telephone_number": "559-268-7613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7120 N Marks Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937110268",
            "country_code": "US",
            "telephone_number": "559-439-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10120 Lanes Bridge Dr",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368890",
            "country_code": "US",
            "telephone_number": "559-431-5532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4291 N Millbrook Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937263438",
            "country_code": "US",
            "telephone_number": "559-224-7967",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "718 E Minarets Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203010",
            "country_code": "US",
            "telephone_number": "559-447-1117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1853 E Niles Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202342",
            "country_code": "US",
            "telephone_number": "559-325-3892",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1942 E Niles Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202344",
            "country_code": "US",
            "telephone_number": "559-323-4957",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "775 E Spruce Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203016",
            "country_code": "US",
            "telephone_number": "559-431-5073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4974 N Fresno st",
            "address_2": "654",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "93726",
            "country_code": "US",
            "telephone_number": "559-826-6281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1415 W Barstow Ave",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113018",
            "country_code": "US",
            "telephone_number": "559-438-9344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLOCUM",
        "first_name": "STACY",
        "middle_name": "LOVELL",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "APCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-18",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT 34689",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.