National Provider Identifier

Stacey M Bevilacqua, LMHC, CASAC, MA

Stacey M Bevilacqua, LMHC, CASAC, MA is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Orchard Park, NY and a listed phone number of (716) 800-1766.

NPI 1619073756Orchard Park, NYMental Health Counselor

Profile Overview

NPI
1619073756
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
September 16, 2006
Last Updated
March 22, 2023

Practice Location

  • 6099 New Taylor RD
  • Right Side
  • Orchard Park, NY 14127-2385

Phone: (716) 800-1766

Mailing Address

  • 6099 New Taylor RD
  • Right Side
  • Orchard Park, NY 14127

Specialties

  • Mental Health Counselor (101YM0800X)
  • Addiction (Substance Use Disorder) Counselor (101YA0400X)
Full Record
NPI
1619073756
Entity Type
Individual
Last Name
Bevilacqua
First Name
Stacey
Middle Name
M
Credential
LMHC, CASAC, MA
Provider Other Last Name
Hassett
Provider Other First Name
Stacey
Provider Other Middle Name
M
Provider Other Credential Text
LMHC, CASAC, MA
Provider Other Last Name Type Code
1
Mailing Street Address
6099 New Taylor RD
Mailing Address Line 2
Right Side
Mailing City
Orchard Park
Mailing State
NY
Mailing ZIP Code
14127
Mailing Country
US
Mailing Phone
(716) 316-4990
Practice Street Address
6099 New Taylor RD
Practice Address Line 2
Right Side
Practice City
Orchard Park
Practice State
NY
Practice ZIP Code
14127-2385
Practice Country
US
Practice Phone
(716) 800-1766
Enumeration Date
September 16, 2006
Last Updated
March 22, 2023
Sex
Female
Sole Proprietor
No
Certification Date
March 22, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X), Addiction (Substance Use Disorder) Counselor (101YA0400X)