Stacy M Pulley, LPC, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

65761 Issued in TX

Practice address

121 S 5TH St
Wills Point, TX 75169-2569

Phone

(903) 312-4259

NPI assigned

Jun 29, 2012

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Professional, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1760746200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 VZ COUNTY ROAD 2512",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751033805",
            "telephone_number": "903-312-4259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S 5TH ST",
            "city": "WILLS POINT",
            "state": "TX",
            "postal_code": "751692569",
            "telephone_number": "903-312-4259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLEY",
        "first_name": "STACY",
        "middle_name": "M",
        "credential": "LPC, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "65761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3185217",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dena Montgomery, CFNP
• Dianne Myers, M.S. CCC-SLP
• Kimberly Dawn Neiman, DDS
• Latitia Phillips
• Premier Country Haven Assisted Living, Inc.
• Holly Renee Randolph, PHARMD
• Dulce Rangel
• Koreigh Redding, RN COCN
• Renaissance Hospital Terrel Inc
• Grace Roberts

• Professional Counselor in Wills Point, TX
• Providers in Wills Point, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.