Stacey L Hunt, PSYD

Key facts

NPI

1497812341

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Psychologist 103TC0700X

License

484 (ND)

Practice address

520 3Rd St NW
Jamestown, ND 58401-2968

Phone

(701) 253-6300

Fax

(701) 253-6400

NPI assigned

Jan 2, 2007

Sex

Female

Sole proprietor

No

Organizations & group practices 7

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.

• Northwest Behavioral Health Clinic Adult Mental Health Clinic/Center · Williston, ND · NPI 1770524613
  Medicare reassignment Care Compare group NPD ND
• Lake Region Behavioral Health Clinic Mental Health Clinic/Center (Including Community Mental Health Center) · Devils Lake, ND · NPI 1669411930
  Medicare reassignment NPD ND
• Northeast Behavioral Health Clinic Mental Health Clinic/Center (Including Community Mental Health Center) · Grand Forks, ND · NPI 1366496341
  Medicare reassignment NPD ND
• South Central Behavioral Health Clinic Mental Health Clinic/Center (Including Community Mental Health Center) · Jamestown, ND · NPI 1225075906
  Medicare reassignment NPD ND
• Inspired Healthcare, PLLC Psychiatric/Mental Health Nurse Practitioner · Jamestown, ND · NPI 1346860541
  NPD
• Northeast Human Service Center Emotionally Disturbed Childrens' Residential Treatment Facility · Grand Forks, ND · NPI 1891808978
  NPD
• South Central Human Service Center Substance Use Disorder Rehabilitation Clinic/Center · Jamestown, ND · NPI 1093542391
  NPD (past)

Medicare Care Compare profile

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Human Service Center (12 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Stacey Gackle Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 23, 2013.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1497812341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2055",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584022055",
            "telephone_number": "701-253-6300",
            "fax_number": "701-253-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584012968",
            "telephone_number": "701-253-6300",
            "fax_number": "701-253-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNT",
        "first_name": "STACEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "GACKLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jamestown, ND

• Debra Horner
• Amanda Joy Huber, PA-C
• Morgan M. Huber
• Geoffrey A Hunt, LAC
• Madelyn Sarah Hunt, M.S., CF-SLP
• Steve Inglish, MD
• Innovis Health, LLC.
• Inspired Healthcare, PLLC
• Christopher Irmen, MD
• Kenn E Iverson, DC PC

All providers in Jamestown, ND · Clinical Psychologist in North Dakota