Alicia Stacks, M.A., CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

100430 Issued in TX

Practice address

101 Miller Dr
Brownwood, TX 76801-5949

Phone

(325) 643-9555

NPI assigned

Oct 29, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1538703046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 WINDCREST DR",
            "city": "EARLY",
            "state": "TX",
            "postal_code": "768022353",
            "telephone_number": "817-219-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MILLER DR",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015949",
            "telephone_number": "325-643-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKS",
        "first_name": "ALICIA",
        "credential": "M.A., CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "100430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY",
            "identifier": "100430",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Sommer
• Sound Mind P&W, PLLC
• Sheila Dawn Spears, FNP-C
• Samuel Blake St Ama
• Lori Dianne St.Ama, LPC
• Tanya R Stephanson, PH.D.
• Stephen P. Kelly, M.D., P.a.
• Sara Louise Stephenson, PA-C
• Daena Castillo Stewardson, LPC
• Daniel Jason Stewart, M.D.

• Speech-Language Pathologist in Brownwood, TX
• Providers in Brownwood, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; 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.