Active NPI
Stacy Bruton
- Professional Counselor
- Sacramento, CA
National Provider Identifier
1912690066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 22080
- Practice address
- 711 G St
Sacramento, CA 95814-1212 - Phone
- (999) 999-9999
- NPI assigned
- Jun 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 119649 | IA | |
| Professional Counselor | 101YP2500X | 22080 | CA | Primary |
Addresses
Primary practice location
711 G St
Sacramento, CA 95814-1212
Mailing address
1625 E 8TH St Apt 32
Davis, CA 95616-2445
Phone (515) 339-2464
Other practice location 1
6200 Aurora Ave Ste 305E
Urbandale, IA 50322-2863
Phone (515) 724-8920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 20, 2025 through Nov 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119649 | IA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth and Shelter Services, Inc. | Mental Health | Past | Accepting new patients |
| Mosaic Family Counseling Center, Inc. | Mental Health | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/yss/r4/
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.
-
- Mental Health Counselor
- Urbandale, IA
- NPI 1417103649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778112000000",
"number": "1912690066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1625 E 8TH ST APT 32",
"city": "DAVIS",
"state": "CA",
"postal_code": "956162445",
"telephone_number": "515-339-2464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 G ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958141212",
"telephone_number": "999-999-9999"
}
],
"practiceLocations": [
{
"address_1": "6200 Aurora Ave Ste 305E",
"address_purpose": "LOCATION",
"city": "Urbandale",
"state": "IA",
"postal_code": "503222863",
"country_code": "US",
"telephone_number": "515-724-8920",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRUTON",
"first_name": "STACY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-02",
"last_updated": "2026-05-07",
"certification_date": "2026-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "119649",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "22080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.