Stacy Michelle Humphrey, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P0706030 Issued in AR

Practice address

1400 College Dr
Texarkana, TX 75503-3536

Phone

(903) 791-1110

NPI assigned

Jul 30, 2008

Sex

Female

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 TX

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Texas Border Health ClinicGroup PAC ID 8820038565, 55 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.

• East Texas Border Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1023630969
  Medicare reassignment Care Compare group
• East Texas Border Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Texarkana, TX
  • NPI 1053663690
  NPD
• East Texas Border Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1558329797
  NPD
• East Texas Border Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Texarkana, TX
  • NPI 1598366718
  NPD
• East Texas Border Health Clinic

  • Community/Retail Pharmacy
  • Marshall, TX
  • NPI 1073485082
  NPD (past)
• East Texas Border Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Marshall, TX
  • NPI 1700134996
  NPD (past)
• Southwest Arkansas Counseling and Mental Health Center, Inc

  • Community/Behavioral Health Agency
  • Texarkana, AR
  • NPI 1598761553
  NPD (past)
• Texarkana Counseling Services, LLC

  • Mental Health Counselor
  • Texarkana, AR
  • NPI 1073012712
  NPD (past)

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1487810396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1326",
            "city": "MARSHALL",
            "state": "TX",
            "postal_code": "756711326",
            "telephone_number": "903-927-3782",
            "fax_number": "903-927-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 COLLEGE DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033536",
            "telephone_number": "903-791-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "STACY",
        "middle_name": "MICHELLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "61024",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0706030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Phay Huddleston, FNP
• John E Hueter, MD
• Jessica Leigh Huett, CRNA
• Tiffany A Hughes, APRN, AGNP-C
• Charles Brady Humphrey, PA
• Cheryl Ann Hunter
• George R Hunter, MD
• David Hurlburt, LPC
• James Michael Hurley, M.D.
• Fred Atkinson Hutcheson Jr., M.D.

• Professional Counselor in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.