Stacy R Desmond, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

02095 Issued in MN

Practice address

1364 White Pine Dr
Cloquet, MN 55720-7511

Phone

(218) 591-7375

NPI assigned

Dec 8, 2022

Last updated

Dec 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1710698956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 WHITE PINE DR",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557207511",
            "telephone_number": "218-591-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 WHITE PINE DR",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557207511",
            "telephone_number": "218-591-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESMOND",
        "first_name": "STACY",
        "middle_name": "R",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "02095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL CLINICAL COUNSELING",
            "identifier": "84-4812831",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Desmondcounseling@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1364 White Pine Dr",
            "city": "Cloquet",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557207511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christine Davis, N.P.
• Donna Peacock Davis
• Alexis Decker
• Naomi Defoe
• Jennifer Deming, RN, CNP
• Amanda Jo Dewitt, RN BSN PHN
• Mark Edward Dewitt, STS, NET STUDY2.0
• Annabelle Doble
• Heidi Doble
• Cindy Doe, RPH

• Professional Counselor in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.