Individual provider Active NPI

Lindsay Stack, LMHC, CADC

  • Mental Health Counselor
  • Waterloo, IA
National Provider Identifier
1659779528
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001437 Issued in IA
Practice address
3362 University Ave
Waterloo, IA 50701-2006
Phone
(319) 235-6571
Fax
(319) 235-6028
NPI assigned
Dec 9, 2014
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12062 IA
Mental Health Counselor 101YM0800X 001437 IA Primary

Addresses

Primary practice location

3362 University Ave
Waterloo, IA 50701-2006

Mailing address

3362 University Ave
Waterloo, IA 50701-2006
Phone (319) 235-6571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20231213001130 IA Practitioner - Mental Health Counselor 5193174357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pathways Behavioral Services IncGroup PAC ID 3779582796, 16 clinicians

Practice addresses (Care Compare)

111 10TH St SW
Pathways Behavioral Services
Waverly, IA 50677-2925
Phone (319) 235-6571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12062IAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Behavioral Services Inc CurrentSince Jan 1, 2024 Accepting new patients
Pathways Behavioral Services Inc Addiction (Substance Use Disorder) CurrentSince Jan 1, 2024 Accepting new patients
Pathways Behavioral Services, Inc. Past Accepting new patients

Locations

602 S Washington Ave
Fredericksburg, IA 50630
Phone (319) 235-6571

3362 University Ave
Waterloo, IA 50701
Phone (319) 235-6571

111 10th St SW
Waverly, IA 50677
Phone (319) 235-6571

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": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1659779528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3362 UNIVERSITY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012006",
            "telephone_number": "319-235-6571",
            "fax_number": "319-235-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3362 UNIVERSITY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012006",
            "telephone_number": "319-235-6571",
            "fax_number": "319-235-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "LINDSAY",
        "credential": "LMHC, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "12062",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.