Stacey Clare Hostetter

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

NA Issued in MN

Practice address

11660 Round Lake Blvd NW
Coon Rapids, MN 55433-2638

Phone

(763) 767-3350

NPI assigned

Feb 20, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1861257685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 243RD AVE NW",
            "city": "SAINT FRANCIS",
            "state": "MN",
            "postal_code": "550708777",
            "telephone_number": "763-232-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11660 ROUND LAKE BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332638",
            "telephone_number": "763-767-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSTETTER",
        "first_name": "STACEY",
        "middle_name": "CLARE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Light LLC
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• Chelsie Nicole Horner, PA-C
• Hospital Doctors LTD.
• Christine Hoth
• Bryan T Hotujec, M.D.
• Jenna Marie House, MA, LPCC
• Rachel Marie Hovda, DNP, FNP-C
• Phillip C Hoversten, M.D.

• Clinical Psychologist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.