Stacey Anne Blank, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3353 Issued in CO

Practice address

1401 S Taft Ave Ste 206
Loveland, CO 80537

Phone

(970) 381-1239

NPI assigned

Oct 11, 2005

Last updated

Nov 9, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573257600000",
    "number": "1871581231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 GEORGETOWN DR",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805386231",
            "telephone_number": "970-381-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S TAFT AVE STE 206",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "80537",
            "telephone_number": "970-381-1239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "928 12th St",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806314024",
            "country_code": "US",
            "telephone_number": "970-352-1056 x4931",
            "fax_number": "970-336-5002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2101 Gay St",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805011307",
            "country_code": "US",
            "telephone_number": "970-381-1239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANK",
        "first_name": "STACEY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2019-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "3353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Loveland, CO
• Providers in Loveland, CO by specialty
• Mental Health Counselor in Colorado

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