Stacy R Roman, LMHC INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

24189 Issued in FL

Practice address

8 Oakleaf Way
Palm Coast, FL 32137-9800

Phone

(702) 300-0349

NPI assigned

Nov 30, 2023

Sex

Female

Sole proprietor

Yes

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 FL, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

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.

• Talkspace Medical Services Ny PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1790475556

  Single Specialty

  Medicare reassignment NPD
• Talkspace Provider Network PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1639814049

  FL, Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1972379857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 OAKLEAF WAY",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321379800",
            "telephone_number": "702-300-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 OAKLEAF WAY",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321379800",
            "telephone_number": "702-300-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "STACY",
        "middle_name": "R",
        "credential": "LMHC INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "24189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joni Lyn Rodriguez, M.A.
• Kristine Frances Rodriguez, COTA/L
• Luke S Rogers
• Rachel Rogers, FNP-BC
• Robert Graham Rollins
• Robert A Rombola
• Virnalisa Romine, M.S. CCC-SLP
• Coral Rosario Garcia, DC
• Rosario Speech Language Therapy Services PLLC
• Ava Olivia Rose

• Mental Health Counselor in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.