Active NPI
Stacie Ann Burdge, LCPC
- Professional Counselor
- Hagerstown, MD
National Provider Identifier
1992018170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC3567
- Practice address
- 1180 Professional CT
Hagerstown, MD 21740-5852 - Phone
- (301) 791-3045
- Fax
- (240) 313-3071
- NPI assigned
- Jul 16, 2010
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC3567 | MD | Primary |
Addresses
Primary practice location
1180 Professional CT
Hagerstown, MD 21740-5852
Mailing address
1180 Professional CT
Hagerstown, MD 21740-5852
Phone (301) 791-3045
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC3567 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279238400000",
"number": "1992018170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1180 PROFESSIONAL CT",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217405852",
"telephone_number": "301-791-3045",
"fax_number": "240-313-3071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 PROFESSIONAL CT",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217405852",
"telephone_number": "301-791-3045",
"fax_number": "240-313-3071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDGE",
"first_name": "STACIE",
"middle_name": "ANN",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-16",
"last_updated": "2010-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC3567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.