Active NPI
Stacey Polson, MS, LPC, NBCC
- Mental Health Counselor
- Lander, WY
National Provider Identifier
1972176931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-1967
- Practice address
- 2754 Sinks Canyon Rd
Lander, WY 82520-9714 - Phone
- (307) 349-6012
- NPI assigned
- Jul 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | LPC-1967 | WY | Primary |
Addresses
Primary practice location
2754 Sinks Canyon Rd
Lander, WY 82520-9714
Mailing address
2754 Sinks Canyon Rd
Lander, WY 82520-9714
Phone (307) 349-6012
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-1967 | WY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1972176931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2754 SINKS CANYON RD",
"city": "LANDER",
"state": "WY",
"postal_code": "825209714",
"telephone_number": "307-349-6012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2754 SINKS CANYON RD",
"city": "LANDER",
"state": "WY",
"postal_code": "825209714",
"telephone_number": "307-349-6012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLSON",
"first_name": "STACEY",
"name_prefix": "Mrs.",
"credential": "MS, LPC, NBCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-19",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WY",
"license": "LPC-1967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lander, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.