Stacey Deann Cruse, PASTORAL COUNSELOR

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

263317 Issued in KY

Practice address

71 Cavalier Blvd #303
Florance, KY 41042

Phone

(859) 282-0204

Fax

(859) 282-0361

NPI assigned

Jul 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stacey Deann Cruse Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Inspiring Hope Counseling Services LLC

  • Mental Health Counselor
  • Erlanger, KY
  • NPI 1063975100

  Mental Health

  NPD

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1710596010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 CAVALIER BLVD #303",
            "city": "FLORANCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-282-0204",
            "fax_number": "859-282-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 CAVALIER BLVD #303",
            "city": "FLORANCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-282-0204",
            "fax_number": "859-282-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUSE",
        "first_name": "STACEY",
        "middle_name": "DEANN",
        "credential": "PASTORAL COUNSELOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "263317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100627070",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "CRUSE",
            "middle_name": "DEANN",
            "credential": "LICENSED PASTORAL CO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.