Stacey M Bevilacqua, LMHC, CASAC, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

004210-01 Issued in NY

Practice address

6099 New Taylor Rd
Right Side
Orchard Park, NY 14127-2385

Phone

(716) 800-1766

NPI assigned

Sep 16, 2006

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

Other names 1

• Stacey M Hassett Former name

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1619073756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6099 NEW TAYLOR RD",
            "address_2": "RIGHT SIDE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "14127",
            "telephone_number": "716-316-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6099 NEW TAYLOR RD",
            "address_2": "RIGHT SIDE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272385",
            "telephone_number": "716-800-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVILACQUA",
        "first_name": "STACEY",
        "middle_name": "M",
        "credential": "LMHC, CASAC, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "22894",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004210-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "HASSETT",
            "middle_name": "M",
            "credential": "LMHC, CASAC, MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Evan Biddlecom
• Halley Anne Biersbach, PA-C
• Nicole Marie Biersbach, RPA C

• Mental Health Counselor in Orchard Park, NY
• Providers in Orchard Park, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.