Stacey G. Wood, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC4441 Issued in ME

Practice address

415 Water St
Ellsworth, ME 04605-2116

Phone

(207) 610-8018

NPI assigned

Nov 6, 2012

Last updated

May 5, 2015By the provider in NPPES

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

Other names 1

• Ms. Stacey G Mason Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health and Counseling Services

  • Community Based Hospice Care Agency
  • Bangor, ME
  • NPI 1508921842
  NPD (past)

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1982958344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 906",
            "city": "MOUNT DESERT",
            "state": "ME",
            "postal_code": "046600906",
            "telephone_number": "207-266-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 WATER ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052116",
            "telephone_number": "207-610-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "STACEY",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC4441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "MASON",
            "middle_name": "G",
            "prefix": "MS.",
            "credential": "LCPC-CC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sheri Wilder, RDH
• Sterling Craige Williamson, MD
• Carol E Willliams, RDH
• Lori L Wilson, LCSW
• Tess Wiskel
• Jami L Woods, MHRT-CSP
• Kiana Marie Woodworth
• Philip C. Wormuth, MHRT-CSP
• Cynthia Hathaway Wright, LCSW
• Kevin Wright, DMD

• Professional Counselor in Ellsworth, ME
• Providers in Ellsworth, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.