Stacey Brandt Millina, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

269952 Issued in MA

Practice address

100A Haverhill St
Methuen, MA 01844-4297

Phone

(978) 682-5276

NPI assigned

Apr 17, 2008

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 NH, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Beth Israel Lahey Health Specialty Care, Inc.

  • Internal Medicine Physician
  • Gloucester, MA
  • NPI 1235147760
  Medicare reassignment NPD
• Northeast Hospital Corporation

  • Psychiatric Hospital Unit
  • Beverly, MA
  • NPI 1407827710
  NPD (past)

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1841464146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100A HAVERHILL ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444297",
            "telephone_number": "603-889-6147",
            "fax_number": "603-883-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100A HAVERHILL ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444297",
            "telephone_number": "978-682-5276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Prospect St.",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "03060",
            "country_code": "US",
            "telephone_number": "603-889-6147",
            "fax_number": "603-594-9649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLINA",
        "first_name": "STACEY",
        "middle_name": "BRANDT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MA",
            "license": "269952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Augustus Miele I
• Kaitlyn Miele
• Cynthia J Miller, PTA
• Ian J Miller, OTR, OTL
• Brian S Millett, DMD
• Nicole Milone
• George F Mingins, LIC. AC.
• Christopher Lawrence Minor
• Joshua James Moen, MD
• Lubna Moheeddin

• Child & Adolescent Psychiatry Physician in Methuen, MA
• Providers in Methuen, MA by specialty
• Child & Adolescent Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.