Individual provider Active NPI

Tammy Kay Stutler, MS, LPC

  • Mental Health Counselor
  • Bridgeport, WV
National Provider Identifier
1922354331
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3059 Issued in WV
Practice address
120 Professional PL Ste 101
Bridgeport, WV 26330-4599
Phone
(304) 513-3495
NPI assigned
Aug 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3059 WV Primary
Professional Counselor 101YP2500X 6487 SC

Addresses

Primary practice location

120 Professional PL Ste 101
Bridgeport, WV 26330-4599

Mailing address

801 47TH Ave N
Myrtle Beach, SC 29577-5402
Phone (843) 997-1538

Other practice location 1

801 47th Ave N
Myrtle Beach, SC 29577-5402
Phone (843) 997-1538

Other identifiers 1

IdentifierTypeStateIssuer
376241MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20250224003518 WV Practitioner - Mental Health Counselor 3375081250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grandw IncGroup PAC ID 9739324922, 93 clinicians
Appalachian Counseling Center LLCGroup PAC ID 5597115782, 20 clinicians

Practice addresses (Care Compare)

120 Professional PL
Bridgeport, WV 26330-4599
Phone (304) 460-5123

207 Fairmont Ave
Fairmont, WV 26554-2710
Phone (689) 404-6869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6487SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Counseling Center LLC Mental Health CurrentSince Feb 23, 2025 Accepting new patients
GR&W, Inc Past Accepting new patients

Locations

207 Fairmont Ave
Fairmont, WV 26554
Phone (681) 404-6869

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1922354331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 47TH AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775402",
            "telephone_number": "843-997-1538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL PL STE 101",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263304599",
            "telephone_number": "304-513-3495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 47th Ave N",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295775402",
            "country_code": "US",
            "telephone_number": "843-997-1538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUTLER",
        "first_name": "TAMMY",
        "middle_name": "KAY",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "3059",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "6487",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376241",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.