Stacey Dyjewski, LCMHCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

S14065 Issued in NC

Practice address

10580 Ligon Mill Rd # 210
Wake Forest, NC 27587-6090

Phone

(919) 263-9592

NPI assigned

Feb 19, 2014

Last updated

Mar 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Perkins Counseling and Psychological Services, PLLC

  • Mental Health Counselor
  • Wake Forest, NC
  • NPI 1750641213
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1912322561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10580 LIGON MILL RD # 210",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876090",
            "telephone_number": "586-804-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10580 LIGON MILL RD # 210",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876090",
            "telephone_number": "919-263-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYJEWSKI",
        "first_name": "STACEY",
        "credential": "LCMHCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014097",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "S14065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Dunn, MMP, LMBT (NC#11271)
• Laurie A Dunne, PA
• Laura Dunston, LCSW
• Tahirah Dutton
• Kelsey Lynn Dyer, NP
• Dynamic Healthcare Solutions, Inc.
• Mackenzie Edwards Dziedzic, OD
• Derek Paul Easley, LCSW
• Edc Drug Stores Inc (Rite Aid Pharmacy 11384)
• Edmond W Suh DDS PA

• Professional Counselor in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.