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Active NPI 1306182795 Individual Practitioner Male Practitioner

John Leroy Stacy , CSAC, LPC

Counselor - Professional • Norfolk, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

John Stacy, CSAC, LPC is a certified Counselor - Professional practicing in Norfolk, VA. With approximately 14 years of clinical experience since completing medical education in 2012, John Stacy delivers high-quality medical care to the local community at 1216 GRANBY ST STE 211.

John Stacy accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1216 Granby St Ste 211

Norfolk, VA 235102622

Telephone 7576320343
Associated Practice Facility / Clinic
🏢 Redefine Therapy, Llc Facility NPI 1245936616

Medicare Profile & Education

Medical School

Other

Graduation Year

2012

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Norfolk, VA

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
14 Yrs -3.2 yrs vs City Avg
City Avg: 17.2 Yrs
State Avg: 14.7 Yrs
Regional Practice Density
206 Specialists

Practicing in Norfolk, VA (6609 Statewide)

Telehealth Adoption Rate
5.3% 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. Stacy (14 Years) 14 Yrs
Norfolk Specialty Average (17.2 Years) 17.2 Yrs

Medical Specialties & State Licenses

CMS Verified: 2024-04-17
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License VA 0701006465

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License VA 0710102681

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1245936616 (VA)

Practice Associates & Co-Workers

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

1 Associated Practitioners
Elizabeth Wieschhaus

Counselor - Professional

NPI 1750891263

Career & Practice History Timeline

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

14 Historical Events
📍
Updated Practice Location April 17, 2024

Registered at 1216 GRANBY ST STE 211, NORFOLK, VA 235102622 (Tel: 7576320343)

📍
Updated Business Mailing Address April 17, 2024

Registered at 1216 GRANBY ST STE 211, NORFOLK, VA 235102622 (Tel: 7576320343)

📍
Updated Practice Location August 17, 2023

Registered at 900 GRANBY ST STE 221, NORFOLK, VA 235102568 (Tel: 7576320343)

📍
Updated Business Mailing Address August 17, 2023

Registered at 900 GRANBY ST STE 221, NORFOLK, VA 235102568 (Tel: 7576320343)

📍
Updated Practice Location February 07, 2023

Registered at 1425 QUEENS WAY, NORFOLK, VA 235172253 (Tel: 7576320343)

📍
Updated Practice Location October 08, 2019

Registered at 409 BIRDNECK CIR, VIRGINIA BEACH, VA 23451 (Tel: 7573856954)

📍
Updated Business Mailing Address October 08, 2019

Registered at 1425 QUEENS WAY, NORFOLK, VA 235172253 (Tel: 5405588593)

👤
Provider Name / Credentials Updated October 08, 2019

Recorded as JOHN STACY, CSAC, LPC

NPI Profile Active December 12, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location December 12, 2012

Registered at 3300 GALLOWS RD, FALLS CHURCH, VA 220423307 (Tel: 7037767777)

📍
Updated Business Mailing Address December 12, 2012

Registered at 12321 STRONG CT, FAIRFAX, VA 220332848 (Tel: 5405588593)

👤
Provider Name / Credentials Updated December 12, 2012

Recorded as JOHN STACY, CSAC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 12, 2012

Counselor (License #0710102681 in VA)

🟢
Initial NPI Registration & Enumeration December 12, 2012

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: 1306182795
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 12, 2012
Last Update: April 17, 2024
Sole Proprietor: Yes

Mailing Address

1216 Granby St Ste 211

Norfolk, VA 235102622

Phone: 7576320343

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.