Mandy Leigh Stacks, LPC, ADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

9989 Issued in SC

Practice address

320 Midland Pkwy Ste C
Summerville, SC 29485-7195

Phone

(803) 577-0265

NPI assigned

Feb 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Charleston Counseling Center PC

  • Mental Health Counselor
  • Mount Pleasant, SC
  • NPI 1316375678

  Professional

  NPD
• Myrtle Beach Counseling Center

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1235784661
  NPD (past)

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1821458225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 SAINT CATHERINES CT",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294839055",
            "telephone_number": "803-577-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 MIDLAND PKWY STE C",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294857195",
            "telephone_number": "803-577-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACKS",
        "first_name": "MANDY",
        "middle_name": "LEIGH",
        "credential": "LPC, ADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "9989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AD08LA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay L Spurgeon, NNP-BC
• Julia Katherine Spurlock, P.A-C
• SST America, LLC
• Michael Stachecki
• Tashia Stackhouse-Geiger, LPC, LPCS, LMHC,
• Shannon Stafford
• Jordan Tyler Staires, PHARMD
• William Kurt Staley, D.C.
• Natalie Nicole Stanley
• Gabrielle Stapf

• Professional Counselor in Summerville, SC
• Providers in Summerville, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.