Individual provider Active NPI

Stacey Lynn Crandall, MS, NCC

  • Professional Counselor
  • Morgantown, WV
National Provider Identifier
1942370911
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2072 Issued in WV
Practice address
100 Corporate Dr
Morgantown, WV 26501-4580
Phone
(304) 241-1766
Fax
(304) 381-2648
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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 P54457 NY
Professional Counselor 101YP2500X 2072 WV Primary

Addresses

Primary practice location

100 Corporate Dr
Morgantown, WV 26501-4580

Mailing address

648 Rockley Rd
Morgantown, WV 26508-2931
Phone (304) 777-8620

Other names 1

  • Stacey Lynn Croscut Former name

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
I20240111000592 WV Practitioner - Mental Health Counselor 5597116863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountaineer Psychological ServicesGroup PAC ID 5799074191, 4 clinicians

Practice addresses (Care Compare)

100 Corporate Dr
Morgantown, WV 26501-4580
Phone (304) 241-1766

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P54457NYMDMental Health Counselor
2072WVMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mountaineer Psychological Services, PLLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

4000 Coombs Farm Rd
Ste 102
Morgantown, WV 26508
Phone (304) 241-1766

100 Corporate Dr
Morgantown, WV 26501
Phone (304) 241-1766

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1942370911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 ROCKLEY RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265082931",
            "telephone_number": "304-777-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CORPORATE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265014580",
            "telephone_number": "304-241-1766",
            "fax_number": "304-381-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "MS, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P54457",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "CROSCUT",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.