Active NPI
Stacy R Gerson, LPC
- Professional Counselor
- Tempe, AZ
National Provider Identifier
1831960764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC22304
- Practice address
- 1631 E Guadalupe Rd Ste 102
Tempe, AZ 85283-3935 - Phone
- (480) 409-5641
- NPI assigned
- Jan 10, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC22304 | AZ | Primary |
Addresses
Primary practice location
1631 E Guadalupe Rd Ste 102
Tempe, AZ 85283-3935
Mailing address
692 E Colt CT
Chandler, AZ 85225-1330
Phone (520) 405-5211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 3, 2024 through Sep 3, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC22304 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1831960764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "692 E COLT CT",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852251330",
"telephone_number": "520-405-5211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1631 E GUADALUPE RD STE 102",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852833935",
"telephone_number": "480-409-5641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERSON",
"first_name": "STACY",
"middle_name": "R",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-10",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC22304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.