Individual provider Active NPI

Stacie Ann Selfe, LMFT

  • Marriage & Family Therapist
  • Covington, KY
National Provider Identifier
1912102807
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
106452 Issued in KY
Practice address
20 West 18TH Street
Covington, KY 41011-3329
Phone
(859) 757-0717
Fax
(859) 331-2425
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001042 GA
Marriage & Family Therapist 106H00000X 106452 KY Primary

Addresses

Primary practice location

20 West 18TH Street
Covington, KY 41011-3329

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 757-0717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240508001994 KY Practitioner - Marriage and Family Therapist 4880035898 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFT001042GAMDMarriage & Family Therapist
106452KYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Marriage & Family Therapist CurrentSince Mar 13, 2024 Accepting new patients
Summit Medical Group, Inc. CurrentSince Mar 13, 2024 Accepting new patients

Locations

6105 1st Financial Dr
Burlington, KY 41005
Phone (859) 525-1846

20 W 18th St
Covington, KY 41011
Phone (859) 757-0717

351 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 572-2000

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: sselfe287144@direct-prd.stelizabeth.com

Organizations & group practices 2

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1912102807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-757-0717",
            "fax_number": "859-331-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WEST 18TH STREET",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113329",
            "telephone_number": "859-757-0717",
            "fax_number": "859-331-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELFE",
        "first_name": "STACIE",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001042",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "106452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

Verify at the official NPI Registry.