Stacy Renee Wengert, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2021040969 Issued in MO

Practice address

406 N Spring St Ste 2
Perryville, MO 63775-1912

Phone

(573) 547-8305

Fax

(573) 547-8306

NPI assigned

Oct 14, 2021

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

Medicare fee-for-service enrollment

Enrolled in MO

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

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.

• Community Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cape Girardeau, MO
  • NPI 1235244757
  Medicare reassignment NPD
• Community Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cape Girardeau, MO
  • NPI 1861154130
  NPD (past)

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1780347054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037536",
            "telephone_number": "573-334-1100",
            "fax_number": "573-651-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N SPRING ST STE 2",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751912",
            "telephone_number": "573-547-8305",
            "fax_number": "573-547-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGERT",
        "first_name": "STACY",
        "middle_name": "RENEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2021040969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri Urhahn
• Cody James Van de Ven, DPT
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0082)
• Walgreen Co (Walgreens #10908)
• Dawn Shelley Wann, LPC
• Carol A Wichern
• Gary R Williams, CRNA
• Emma Nichole Winkler
• Nicola Wissler, LCSW
• Amanda Wozniak, PHARMD

• Professional Counselor in Perryville, MO
• Providers in Perryville, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.