Stacy Reuille-Dupont, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

4577 Issued in CO

Legal business name

STACY REUILLE-DUPONT, LLC

Practice address

1305 Escalante Dr # 203
Durango, CO 81303-8931

Phone

(970) 749-8227

NPI assigned

Apr 17, 2018

Last updated

Jul 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Stockton, CCMA, BSHM

Title

Office Manager

Phone

(970) 422-1761

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Miranda Day, LPC

  • Mental Health Counselor
  • Durango, CO
  • NPI 1396338067
  Medicare reassignment NPD
• Stacy Ann Reuille Dupont, PHD

  • Clinical Psychologist
  • Durango, CO
  • NPI 1851628713
  Medicare reassignment NPD
• Janet Marie Wolf, CMT, LCSW

  • Clinical Social Worker
  • Durango, CO
  • NPI 1013138452
  NPD (past)

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1740777507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 ESCALANTE DR # 203",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813038931",
            "telephone_number": "970-749-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 ESCALANTE DR # 203",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813038931",
            "telephone_number": "970-749-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY REUILLE-DUPONT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-17",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "STOCKTON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "970-422-1761",
        "authorized_official_credential": "CCMA, BSHM"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CO",
            "license": "4577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49670379",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melaney Sreenan, PH.D. M.S.W.
• SSC Durango Operating Company LLC (Four Corners Health Care Center)
• SSC Durango Operating Company LLC (Four Corners Health Care Center)
• Amanda Beth St Pierre, DPT
• Sarah St. John
• Patricia Anne Stady, RN
• Penney Sutcliffe Stahl
• Steven Stahl, RN
• Susannah Marie Standal, O.D.
• Cynthia M Stangby

• Adult Mental Health Clinic/Center in Durango, CO
• Providers in Durango, CO by specialty
• Adult Mental Health Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.