Individual provider Active NPI

Stacy Laluzerne, LPC IT

  • Professional Counselor
  • Green Bay, WI
National Provider Identifier
1831897701
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7266-326 Issued in WI
Practice address
3150 Gershwin Dr
Green Bay, WI 54311-4328
Phone
(920) 391-4811
Fax
(920) 391-4811
NPI assigned
Feb 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7266-326 WI Primary

Addresses

Primary practice location

3150 Gershwin Dr
Green Bay, WI 54311-4328

Mailing address

3150 Gershwin Dr
Green Bay, WI 54311-4328
Phone (920) 391-4811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20240110002905 WI Practitioner - Mental Health Counselor 2062863467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay Area Behavioral HealthGroup PAC ID 2365952066, 3 clinicians

Practice addresses (Care Compare)

1150 Springhurst Dr
Suite 102
Green Bay, WI 54304-5950
Phone (920) 393-1304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7266-326WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Brown CurrentSince Jun 14, 2024 Accepting new patients
County of Brown CurrentSince Jun 14, 2024 Accepting new patients

Locations

3150 Gershwin Dr
Green Bay, WI 54311
Phone (920) 391-4700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1831897701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114328",
            "telephone_number": "920-391-4811",
            "fax_number": "920-391-4731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114328",
            "telephone_number": "920-391-4811",
            "fax_number": "920-391-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALUZERNE",
        "first_name": "STACY",
        "credential": "LPC IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7266-326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.