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Active NPI 1316403892 Individual Practitioner Male Practitioner

Brendan Stack , LPC, LADC

Counselor - Professional • Southbury, CT

Professional Overview & Biography Verified Profile Summary

Brendan Stack, LPC, LADC is a certified Counselor - Professional practicing in Southbury, CT. With approximately 8 years of clinical experience since completing medical education in 2018, Brendan Stack delivers high-quality medical care to the local community at 519 HERITAGE RD STE 2A5.

Brendan Stack does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

519 Heritage Rd Ste 2a5

Southbury, CT 064886694

Telephone 5186104528
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2018

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Southbury, CT

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
8 Yrs -7.3 yrs vs City Avg
City Avg: 15.3 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
23 Specialists

Practicing in Southbury, CT (2870 Statewide)

Telehealth Adoption Rate
4.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Stack (8 Years) 8 Yrs
Southbury Specialty Average (15.3 Years) 15.3 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-07-18
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License CT 4530

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License CT 001323

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Jacob Nicholls , LCSW

Social Worker - Clinical

NPI 1134907942

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location May 09, 2025

Registered at 519 HERITAGE RD STE 2A5, SOUTHBURY, CT 064886694 (Tel: 5186104528)

📍
Updated Business Mailing Address May 09, 2025

Registered at 127 WATERTOWN RD, MIDDLEBURY, CT 067621502 (Tel: 5186104528)

📍
Updated Business Mailing Address July 29, 2020

Registered at 45 GREENWICH DR, SOUTHBURY, CT 064882122 (Tel: 5186104528)

👤
Provider Name / Credentials Updated July 29, 2020

Recorded as BRENDAN STACK, LPC, LADC

NPI Profile Active February 20, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location February 20, 2019

Registered at 5 BROOKSIDE AVE # 2, WINSTED, CT 060981101 (Tel: 5186104528)

📍
Updated Business Mailing Address February 20, 2019

Registered at PO BOX 1223, CANAAN, CT 060181223 (Tel: 5186104528)

👤
Provider Name / Credentials Updated February 20, 2019

Recorded as BRENDAN STACK, LADC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 20, 2019

Counselor (License #001323 in CT)

🟢
Initial NPI Registration & Enumeration February 20, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1316403892
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 20, 2019
Last Update: July 18, 2025
Sole Proprietor: Yes

Mailing Address

127 Watertown Rd

Middlebury, CT 067621502

Phone: 5186104528

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.