Stacie L Darke, PHD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6512 Issued in MN

Practice address

1155 Ford Rd Ste B
St Louis Park, MN 55426-1115

Phone

(952) 378-1800

Fax

(952) 378-1714

NPI assigned

Sep 29, 2008

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 MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  Medicare reassignment NPD
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188

  Marriage & Family Therapist

  Medicare reassignment NPD
• Family Support Services Inc.

  • Mental Health Counselor
  • New Brighton, MN
  • NPI 1467549220
  NPD
• Medicine Lake Consultation Group,PLLC

  • Psychiatry Physician
  • St Louis Park, MN
  • NPI 1881753564

  Clinical

  NPD

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1952551731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4240 PARK GLEN RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165427",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 FORD RD STE B",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554261115",
            "telephone_number": "952-378-1800",
            "fax_number": "952-378-1714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4027 County Road 25",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554162629",
            "country_code": "US",
            "telephone_number": "612-925-6033",
            "fax_number": "612-925-8496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6200 Shingle Creek Pkwy Ste 350",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Center",
            "state": "MN",
            "postal_code": "554302155",
            "country_code": "US",
            "telephone_number": "763-503-8560",
            "fax_number": "763-503-8563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DARKE",
        "first_name": "STACIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "6512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Damrow
• Monicka Dang, PT
• Emma Dangers
• Nancy Danielson, CRNA
• Mary Parrish Darden, MD
• Scott Darling
• Kendra Darwin, O.T.
• Mykela Jean Briann Darwin
• Susan Marie Daub, LPCC
• Tamara Christine Dauphin-Whear, LPCC

• Clinical Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.