Charles Benson Stacey, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

CMF0068702 Issued in NM

Practice address

3510 Messina Dr
Farmington, NM 87402-4782

Phone

(832) 630-3022

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 23, 2024 through Sep 23, 2026

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Choices Behavioral Health Services, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Farmington, NM
  • NPI 1134194483
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582934400000",
    "number": "1699985259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 MESSINA DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024782",
            "telephone_number": "832-630-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 MESSINA DR",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874024782",
            "telephone_number": "832-630-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACEY",
        "first_name": "CHARLES",
        "middle_name": "BENSON",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-02-29",
        "certification_date": "2020-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "4426",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "CMF0068702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84254289",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charles@charlesstacey.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3510 Messina Dr",
            "city": "Farmington",
            "state": "NM",
            "country_code": "US",
            "postal_code": "874024782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James J Spence, MD
• Robert F. Sprung Jr., M.D.
• SSS Skincare and Wellness, LLC Dba Skinsationmd
• Rhenna St. Clair
• Michael J St.John, CRNA
• Staci Noyes, D.C., P.C.
• Stacy F. Sandel, LLC
• Rebekah Stamets
• Tabitha Brooke Stanfield
• Chantelle Stanley

• Marriage & Family Therapist in Farmington, NM
• Providers in Farmington, NM by specialty
• Marriage & Family Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.