Individual provider Active NPI

Stephanie Diana Housley, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Burleson, TX
National Provider Identifier
1508535451
Registry record updated Sep 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
L-86581 Issued in VA
Practice address
125 N Wilson St
Burleson, TX 76028-4167
Phone
(817) 382-1314
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X L-86581 TX
Lactation Consultant (Registered Nurse) 163WL0100X L-86581 VA Primary

Addresses

Primary practice location

125 N Wilson St
Burleson, TX 76028-4167

Mailing address

PO Box 40382
Fort Worth, TX 76140-0382
Phone (817) 382-1314

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
Credentials
Bachelor of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
L-86581TXMDLactation Consultant (Registered Nurse)
L-86581VAMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Sunflower Babies LLC CurrentSince Sep 23, 2021 Accepting new patients
Nichole McCloy LLC Dba Fort Worth Lactation & Tongue Tie Specialists Lactation Consultant Past Accepting new patients
Lactation Consultants of America Lactation Consultant Past Accepting new patients

Locations

125 N Wilson St
Burleson, TX 76028
Phone (817) 382-1314

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631923200000",
    "number": "1508535451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40382",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761400382",
            "telephone_number": "817-382-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N WILSON ST",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284167",
            "telephone_number": "817-382-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSLEY",
        "first_name": "STEPHANIE",
        "middle_name": "DIANA",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-18",
        "certification_date": "2021-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "L-86581",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VA",
            "license": "L-86581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2021; 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.