Individual provider Active NPI

Alexandria Nicole Knudsen-Stacey

  • Professional Counselor
  • Austin, TX
National Provider Identifier
1952100364
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
77648 Issued in TX
Practice address
2501 W William Cannon Dr BLDG 4
Austin, TX 78745-5281
Phone
(512) 804-3200
NPI assigned
Mar 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 77648 TX Primary

Addresses

Primary practice location

2501 W William Cannon Dr BLDG 4
Austin, TX 78745-5281

Mailing address

2501 W William Cannon Dr BLDG 4
Austin, TX 78745-5281

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623000217 TX Practitioner - Mental Health Counselor 4486166956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2501 W William Cannon Dr BLDG
4 Stonegate Clinic
Austin, TX 78745-5281
Phone (512) 804-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
77648TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Travis County Mental Health and Mental Retardation Center Professional CurrentSince Apr 17, 2025 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Apr 17, 2025 Accepting new patients

Locations

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

2501 W William Cannon Dr
Bldg 4
Austin, TX 78745
Phone (512) 804-3200

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.

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1952100364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W WILLIAM CANNON DR BLDG 4",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W WILLIAM CANNON DR BLDG 4",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455281",
            "telephone_number": "512-804-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSEN-STACEY",
        "first_name": "ALEXANDRIA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "77648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.