Stacey Rene Le Fevre, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20043223A Issued in IN

Practice address

100 Navarre PL
Ste 5570
South Bend, IN 46601-1169

Phone

(574) 647-8610

NPI assigned

Jun 29, 2010

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

Other identifiers 1

Other names 1

• Stacey Rene Le Fevre Young Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: slefevre@mybeacon.cernerdirect.com

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.

• Beacon Medical Group, Inc.

  dba Beacon Medical Group Schwartz - Wiekamp

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1033161617
  Medicare reassignment Care Compare group NPD
• Beacon Medical Group Inc

  dba Beacon Medical Group Anesthesia Elkhart

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1437803285
  NPD
• Beacon Medical Group, Inc.

  dba Beacon Medical Group Pediatric Multi-Specialty

  • Pediatrics Physician
  • South Bend, IN
  • NPI 1548415474

  Psychologist

  NPD

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1538470018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DRIVE",
            "address_2": "SUITE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465303245",
            "telephone_number": "574-647-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL",
            "address_2": "STE 5570",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011169",
            "telephone_number": "574-647-8610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Navarre Pl",
            "address_2": "Ste 5550",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011169",
            "country_code": "US",
            "telephone_number": "574-647-2550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE FEVRE",
        "first_name": "STACEY",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20043223A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300021361",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "slefevre@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Navarre Pl Ste 5550",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "LE FEVRE YOUNG",
            "middle_name": "RENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Lawrence, DO
• Jeff Lawson, COTA
• Lindsey Dawn Lawson
• Kailyn Lax
• Annalisa Layman, M.A., CCC-SLP
• Thomas Leahy, MD
• Emily Anne Leali
• Debra R Leazenby, OTR
• Matthew Leblang, P.T
• Nicole Lecount

• Clinical Psychologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.