Stacie Michele Betancourt, PH.D

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

AAB2C399BB Issued in CA

Practice address

377 Sites Way
Big Bear City, CA 92314-9178

Phone

(909) 733-2346

NPI assigned

Oct 24, 2025

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

Electronic endpoints 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.

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1761264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1831067586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 SITES WAY",
            "city": "BIG BEAR CITY",
            "state": "CA",
            "postal_code": "923149178",
            "telephone_number": "909-733-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 SITES WAY",
            "city": "BIG BEAR CITY",
            "state": "CA",
            "postal_code": "923149178",
            "telephone_number": "909-733-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "STACIE",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-24",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "CA",
            "license": "AAB2C399BB",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.fourwindsadrcoaching.com/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "As mutual consent between client and medical team",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct corrispondance",
            "address_1": "9222 Svl Box",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923955148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bear Valley Community Health Care District (Bear Valley Rural Health Clinic)
• Bear Valley Hospice LLC
• Joel J Bickler, D.D.S
• Big Bear Cab Company, Inc.
• Big Bear City Community Services District
• Bailee Bock
• Mark William Brown, D.D.S

• Health & Wellness Coach in Big Bear City, CA
• Providers in Big Bear City, CA by specialty
• Health & Wellness Coach in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.