Stacy L. McKenzie-Baca, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

171280 Issued in KY

Practice address

404 Euclid Ave
Paintsville, KY 41240-1167

Phone

(606) 889-1602

Fax

(606) 263-4467

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ohio Valley Physicians IncGroup PAC ID 8729032966, 130 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Ohio Valley Physicians Inc

  dba Access Care

  • Family Medicine Physician
  • Huntington, WV
  • NPI 1962433177

  KY

  Medicare reassignment Care Compare group NPD
• Ohio Valley Physicians Inc

  dba OVP Health

  • Rural Health Clinic/Center
  • Eastern, KY
  • NPI 1164129599
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1528146560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257080390",
            "telephone_number": "304-429-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 EUCLID AVE",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "412401167",
            "telephone_number": "606-889-1602",
            "fax_number": "606-263-4467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "404 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Paintsville",
            "state": "KY",
            "postal_code": "412401167",
            "country_code": "US",
            "telephone_number": "606-889-1602",
            "fax_number": "606-263-4467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE-BACA",
        "first_name": "STACY",
        "middle_name": "L.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "171280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara B Maynard, R.PH.
• Gabrielle McCarty, PT, DPT, MLS(ASCP)CM
• Robin Shirin McFarland, MA
• Carol McGlothen, BA
• Kelly McGuire, APRN
• Tamera J. McKenzie, BSW/PE
• Katherine Marie Meade
• Med Express Pharmacy LLC
• Medical Associates of East Kentucky, PLLC
• Medical Imaging Group, LLC

• Mental Health Counselor in Paintsville, KY
• Providers in Paintsville, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.