Active NPI
Susan Stahlman
- Professional Counselor
- Forney, TX
National Provider Identifier
1912384447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 70804
- Practice address
- 713 W Broad St
Forney, TX 75126-9147 - Phone
- (972) 552-5559
- Fax
- (972) 552-5499
- NPI assigned
- May 5, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 70804 | TX | Primary |
Addresses
Primary practice location
713 W Broad St
Forney, TX 75126-9147
Mailing address
713 W Broad St
Forney, TX 75126-9147
Phone (972) 552-5559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241217004287 | TX | Practitioner - Mental Health Counselor | 0547797326 | Practice locations: Kaufman, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70804 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samantha White LPC LLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Kaufman, TX
- NPI 1467284059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430784000000",
"number": "1912384447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 W BROAD ST",
"city": "FORNEY",
"state": "TX",
"postal_code": "751269147",
"telephone_number": "972-552-5559",
"fax_number": "972-552-5499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "713 W BROAD ST",
"city": "FORNEY",
"state": "TX",
"postal_code": "751269147",
"telephone_number": "972-552-5559",
"fax_number": "972-552-5499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAHLMAN",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-05",
"last_updated": "2015-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "70804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forney, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.