Individual provider Active NPI

Stacey T Hubbard, MA, LPC

  • Professional Counselor
  • Cleveland, OH
National Provider Identifier
1497151286
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C.0900566-CR Issued in OH
Practice address
3500 Carnegie Ave
Cleveland, OH 44115-2641
Phone
(216) 970-9747
NPI assigned
Nov 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C.0900566-CR OH Primary

Addresses

Primary practice location

3500 Carnegie Ave
Cleveland, OH 44115-2641

Mailing address

1193 Tinkers Green Dr
Streetsboro, OH 44241-4996
Phone (216) 970-9747

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240304003499 OH Practitioner - Mental Health Counselor 6608211370 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C.0900566-CROHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone Current Accepting new patients
Ohioguidestone CurrentSince Jan 1, 2024 Accepting new patients
Ohioguidestone CurrentSince Jan 1, 2024 Accepting new patients

Locations

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

434 Eastland Rd
Berea, OH 44017
Phone (440) 260-8327

3500 Carnegie Ave
Cleveland, OH 44115
Phone (440) 260-8327

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1497151286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1193 TINKERS GREEN DR",
            "city": "STREETSBORO",
            "state": "OH",
            "postal_code": "442414996",
            "telephone_number": "216-970-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152641",
            "telephone_number": "216-970-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "STACEY",
        "middle_name": "T",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.0900566-CR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.