Debra Jean Stace, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LMSW-30618 Issued in ID

Practice address

8950 W Emerald St Ste 178
Boise, ID 83704-8296

Phone

(208) 376-7083

NPI assigned

Apr 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1548766611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4722 OXBOW PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837139504",
            "telephone_number": "208-571-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 W EMERALD ST STE 178",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048296",
            "telephone_number": "208-376-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACE",
        "first_name": "DEBRA",
        "middle_name": "JEAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "LMSW-30618",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LMSW-30618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Luke'S Elks Rehab
• St. Luke'S Health System
• St. Luke'S Regional Medical Center (St. Luke's Idaho Cardiology Associates)
• St. Lukes
• Stability Mental Health, PLLC (SMH Academy)
• Julie Lynn Stace, CSFA
• Stacey Titus PLLC (Clearwater Counseling Services)
• Eric Gerand Stackle, MD
• Mary J Stackle, NP
• Daniel John Stackowicz, DDS

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.