MS. BRENDA LEE STACK (NPI# 1689725913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689725913 |
| Entity Type | Individual |
| Full Name | MS. BRENDA LEE STACK |
| Credential | LMHC, CAP, NCC |
| Practice Address |
3302 Green St Mims FL 32754-3813 |
| Mailing Address |
Po Box 321 Mims FL 32754-0321 |
| Practice Telephone | 3212688828 |
| Practice Fax Number | 3215670888 |
| Mailing Telephone | 3212688828 |
| Mailing Fax Number | 3215670888 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2008-07-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH5982 | FL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164851259 | Brenda Stack | Nurse Practitioner | 132 Colonial Dr, Towanda, PA 18848-8107 | 2013-11-08 |
| Street Address |
3302 GREEN ST |
| City | MIMS |
| State | FL |
| Zip Code | 32754-3813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659888725 | Andria Dianna Blanchard | Clinic/Center | 2443 Harry T Moore Ave, Mims, FL 32754 | 2018-01-10 |
| 1346695970 | Joseph Tobia | Pharmacist | 2448 North Us 1 Hwy, Mims, FL 32754 | 2016-05-02 |
| 1932310679 | David Willis Do Pa | Family Medicine | 919 Leather Fern Lane, Mims, FL 32754 | 2007-05-24 |
| 1255487070 | Joy Gail Jobe | Contractor | 4042 Sweet Bay Dr, Mims, FL 32754-2209 | 2007-01-26 |
| 1861672883 | Amy L Sadler | Technician | 4021 Holder Park Dr, Mims, FL 32754-2510 | 2007-11-07 |
| 1710233465 | Nathan Owen Glenn | Physical Therapy Assistant | 3034 Folsom Rd, Mims, FL 32754-2911 | 2012-07-31 |
| 1295110583 | Jennifer Taylor | Physical Therapist | 3218 Legacy Dr, Mims, FL 32754-3022 | 2015-07-28 |
| 1881885242 | Francis Healthcare Center LLC | Pharmacy | 2448 Us Highway 1, Mims, FL 32754-3854 | 2007-08-09 |
| 1194055244 | Rock 3 | Pharmacy | 2448 Us Highway 1, Mims, FL 32754-3854 | 2010-01-12 |
| 1457636367 | Mark Gerstle | Pharmacist | 2475 N Us 1, Mims, FL 32754-3874 | 2011-10-12 |
| Find all providers in zip 32754 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457161 | Jenna Grace Mallek Campos | Counselor | 13626 Phoenix Dr, Orlando, FL 32828-9338 | 2020-11-07 |
| 1295336089 | Resilience Behavioral Health LLC | Counselor | 3211 Calumet Dr, Orlando, FL 32810-2023 | 2020-11-06 |
| 1538760392 | Darcy Lynn Coleman | Counselor | 325 Se 28th Ter, Cape Coral, FL 33904-3416 | 2020-11-06 |
| 1407457203 | Marylon Larkins | Counselor | 1525 W Broadway St, Oviedo, FL 32765-6576 | 2020-11-06 |
| 1639770423 | Nickole Marguerite Wyse | Counselor | 7901 4th St N Ste 4000, St Petersburg, FL 33702-4305 | 2020-11-06 |
| 1275134066 | Hyacinth Anne Morgan | Counselor | 1001 W Cypress Creek Rd Ste 302s, Fort Lauderdale, FL 33309-1950 | 2020-11-06 |
| 1245831288 | John Lopez IIi | Counselor | 3024 Smith Ave, Bradenton, FL 34207-5558 | 2020-11-05 |
| 1326649435 | Taylor Shannon Wolfe | Counselor | 8312 Catria Ln, Lake Worth, FL 33467-6706 | 2020-11-04 |
| 1427659630 | Sherrie Wade | Counselor | 260 Ne Wavecrest Way, Boca Raton, FL 33432-4220 | 2020-11-04 |
| 1396346656 | Ariel K Heyliger St. Fleur | Counselor | 9104 Nw 39th St, Coral Springs, FL 33065-2421 | 2020-11-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.