Stacey King, LPC IT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

11960-125 Issued in WI

Practice address

3900 W Brown Deer Rd Ste 200
Brown Deer, WI 53209-1220

Phone

(414) 540-2170

NPI assigned

Apr 11, 2019

Last updated

Sep 9, 2026By the provider in NPPES

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 King Professional name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  WI

  Medicare reassignment
• Kennedy's Circle of Wellness LLC

  • Mental Health Counselor
  • Milwaukee, WI
  • NPI 1942856091
  NPD (past)
• Cartwheel Health Services PC

  • Child & Adolescent Psychiatry Physician
  • Cambridge, MA
  • NPI 1912633975

  Professional

  NPD (past)

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1649733189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611A N 62ND ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532134171",
            "telephone_number": "414-346-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD STE 200",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091220",
            "telephone_number": "414-540-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "STACEY",
        "credential": "LPC IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18842-130",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11960-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "KING",
            "credential": "SUBSTANCE ABUSE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Caylee Kennedy
• Ryan Jeffrey Kesler, PHARMD
• KH Rhodes to Wellness, LLC
• Kids Discover Success Therapeutics, LLC
• Soo-in Kim
• Robert Michael Kitsis, M.D.
• John Michael Kittelson, MSW, CAPSW
• Natalie Marie Klas, LMFT
• Nicole Klimowicz
• Bradley D Klinger, MA

• Professional Counselor in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.