MR. JOHN LEROY STACY CSAC LPC NPI 1306182795

NPI Information

  • NPI: 1306182795
  • Provider Name: MR. JOHN LEROY STACY, CSAC, LPC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1216 GRANBY ST STE 211
    NORFOLK, VA
    ZIP 23510
  • Phone: (757) 632-0343

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NPI Details

MR. John Leroy Stacy, CSAC, LPC is a professional counselor in Norfolk, VA with 14 years of experience. MR. John Leroy Stacy, CSAC, LPC NPI is 1306182795. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1216 GRANBY ST STE 211
NORFOLK, VA
ZIP 23510-622
Phone: (757) 632-0343

The NPI 1306182795 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 12/12/2012 and was last updated on 4/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)0710102681VIRGINIANo
2101YP2500XCounselorProfessional0701006465VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11245936616MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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