Active NPI
Mitchell Lee Stacy, LMHC
- Mental Health Counselor
- Jeffersonville, IN
National Provider Identifier
1952269060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39005810A
- Practice address
- 590 Missouri Ave
Jeffersonville, IN 47130-3083 - Phone
- (812) 288-4688
- Fax
- (812) 610-8333
- NPI assigned
- Jan 15, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39005810A | IN | Primary |
Addresses
Primary practice location
590 Missouri Ave
Jeffersonville, IN 47130-3083
Mailing address
590 Missouri Ave
Jeffersonville, IN 47130-3083
Phone (812) 288-4688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39005810A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768435200000",
"number": "1952269060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 MISSOURI AVE",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303083",
"telephone_number": "812-288-4688",
"fax_number": "812-610-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 MISSOURI AVE",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303083",
"telephone_number": "812-288-4688",
"fax_number": "812-610-8333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACY",
"first_name": "MITCHELL",
"middle_name": "LEE",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-01-15",
"last_updated": "2026-01-15",
"certification_date": "2026-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39005810A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jeffersonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.