Stacy D Maloney, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC.8252 Issued in SC

Practice address

1297 Professional Dr Ste 102
Myrtle Beach, SC 29577-5713

Phone

(704) 223-1925

NPI assigned

Apr 20, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Graceful Tides Counseling Service LLC

  • Mental Health Counselor
  • Myrtle Beach, SC
  • NPI 1982367645
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1942943535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1297 PROFESSIONAL DR STE 102",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775713",
            "telephone_number": "704-223-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 PROFESSIONAL DR STE 102",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775713",
            "telephone_number": "704-223-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "STACY",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "LPC.8252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Anne Malich
• Walter N. Malloy, M.D.
• Liesl Eva Malone
• Michael Andrew Malone, M.D.
• Katelyn Maloney, CF-SLP
• Man in the Box Anesthesia LLC
• Andrew Peter Mangano, DO
• Nicholas Mankowski
• Matthew C Mann
• Joanna Mannon, ATC, SCAT

• Counselor in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.