Individual provider Active NPI

Stacey Kauffman, LMSW

  • Mental Health Counselor
  • San Antonio, TX
National Provider Identifier
1629760517
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
25664 Issued in MD
Practice address
274 Bobwhite Way
San Antonio, TX 78253-6977
Phone
(210) 793-2284
NPI assigned
May 22, 2023
Last updated
May 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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 25664 MD Primary

Addresses

Primary practice location

274 Bobwhite Way
San Antonio, TX 78253-6977

Mailing address

8101 Sandy Spring Rd Ste 250N
Laurel, MD 20707-3527
Phone (800) 994-5403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, DC, WI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20241125004303 TX Practitioner - Clinical Social Worker 1658806872 Reassigns benefits to 1 organization
I20241127002242 DC Practitioner - Clinical Social Worker 1658806872 Reassigns benefits to 1 organization
I20260323002517 WI Practitioner - Clinical Social Worker 1658806872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25664MDMDMental Health Counselor
62510TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Oct 22, 2024 Accepting new patients
Restore -Recover-Renew LLC CurrentSince Jan 5, 2025 Accepting new patients
Lumvia LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

14743 Old Bandera Rd
Unit 14101
Helotes, TX 78023
Phone (210) 858-6127

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 3

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1629760517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 SANDY SPRING RD STE 250N",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207073527",
            "telephone_number": "800-994-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 BOBWHITE WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782536977",
            "telephone_number": "210-793-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFFMAN",
        "first_name": "STACEY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "25664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.