Active NPI
Lauren F Stack, PH.D.
- Counseling Psychologist
- Great Neck, NY
National Provider Identifier
1992131833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 020184
- Practice address
- 310 E Shore Rd
Suite 100
Great Neck, NY 11023-2410 - Phone
- (516) 466-7077
- Fax
- (516) 466-0450
- NPI assigned
- Sep 24, 2013
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 020184 | NY | Primary |
Addresses
Primary practice location
310 E Shore Rd
Suite 100
Great Neck, NY 11023-2410
Mailing address
310 E Shore Rd
Suite 100
Great Neck, NY 11023-2410
Phone (516) 466-7077
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020184 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481068800000",
"number": "1992131833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 E SHORE RD",
"address_2": "SUITE 100",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110232410",
"telephone_number": "516-466-7077",
"fax_number": "516-466-0450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 E SHORE RD",
"address_2": "SUITE 100",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110232410",
"telephone_number": "516-466-7077",
"fax_number": "516-466-0450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACK",
"first_name": "LAUREN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-24",
"last_updated": "2016-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NY",
"license": "020184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.