Individual provider Active NPI

Stacey Greger

  • Mental Health Counselor
  • Lake Butler, FL
National Provider Identifier
1568022234
Registry record updated Jun 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10767 Issued in FL
Practice address
10 W Main St
Lake Butler, FL 32054-1638
Phone
(352) 374-5600
NPI assigned
Jun 16, 2019
Last updated
Jun 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH10767 FL Primary

Addresses

Primary practice location

10 W Main St
Lake Butler, FL 32054-1638

Mailing address

4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240923004200 FL Practitioner - Mental Health Counselor 9537600135 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH10767FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Behavioral Healthcare, Inc. CurrentSince Jul 19, 2024 Accepting new patients
Meridian Behavioral Healthcare, Inc. CurrentSince Jul 19, 2024 Accepting new patients

Locations

4300 SW 13th St
Gainesville, FL 32608

10 W Main St
Lake Butler, FL 32054
Phone (386) 496-2347

Organizations & group practices 2

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": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560643200000",
    "number": "1568022234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006",
            "telephone_number": "352-374-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W MAIN ST",
            "city": "LAKE BUTLER",
            "state": "FL",
            "postal_code": "320541638",
            "telephone_number": "352-374-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGER",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-16",
        "last_updated": "2019-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Butler, FL

Sources for this page

Verify at the official NPI Registry.