Active NPI
Stacey B Thacker, LMFT
- Marriage & Family Therapist
- Fresno, CA
National Provider Identifier
1962500553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT43024
- Practice address
- 1879 E Fir Ave
Ste 103 Roubicek & Shaw Counseling
Fresno, CA 93720 - Phone
- (559) 323-8484
- Fax
- (559) 323-8686
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT43024 | CA | Primary |
Addresses
Primary practice location
1879 E Fir Ave
Ste 103 Roubicek & Shaw Counseling
Fresno, CA 93720
Mailing address
1879 E Fir Ave
Ste 103
Fresno, CA 93720
Phone (559) 323-8484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 6, 2026 through Apr 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT43024 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roubicek & Thacker | Marriage & Family Therapist | Past | Accepting new patients |
| Roubicek & Shaw | Marriage & Family Therapist | Past | Accepting new patients |
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": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962500553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1879 E FIR AVE",
"address_2": "STE 103",
"city": "FRESNO",
"state": "CA",
"postal_code": "93720",
"telephone_number": "559-323-8484",
"fax_number": "559-323-8686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1879 E FIR AVE",
"address_2": "STE 103 ROUBICEK & SHAW COUNSELING",
"city": "FRESNO",
"state": "CA",
"postal_code": "93720",
"telephone_number": "559-323-8484",
"fax_number": "559-323-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACKER",
"first_name": "STACEY",
"middle_name": "B",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT43024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.