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MR. BRENDAN STACK LPC, LADC
NPI 1316403892
Counselor - Professional in Southbury, CT

Active since February 20, 2019PECOS Enrolled
519 HERITAGE RD STE 2A5, SOUTHBURY, CT 06488(518) 610-4528 Get Directions Write a Review

NPPES record last updated: July 18, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 9, 2025, Jul 29, 2020, Feb 20, 2019 (3 updates tracked since 2019).

About Mr. Brendan Stack Lpc, Ladc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BRENDAN STACK LPC, LADC (NPI 1316403892) is an individual professional provider in Southbury, Connecticut, licensed in Connecticut (4530) and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1316403892
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. BRENDAN STACKCredential: LPC, LADC
Location Address519 HERITAGE RD STE 2A5Southbury, CT 06488-6694
Mailing Address127 Watertown RdMiddlebury, CT 06762-1502 · (518) 610-4528
Phone(518) 610-4528
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateFebruary 20, 2019
Last NPPES UpdateJuly 18, 20253 updates tracked since enumeration
NPPES CertifiedJuly 18, 2025
✔ NPI 1316403892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in CT · 4530
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 001323 (CT)
519 HERITAGE RD STE 2A5, Southbury, CT 06488
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Brendan Stack Lpc, Ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5092211243
PECOS Enrollment IDI20251006001823
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACOB NICHOLLS LCSW
Social Worker (Clinical)
519 HERITAGE RD STE 2A5
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (203) 568-5923
SOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER
Counselor (Mental Health)
519 HERITAGE RD STE 2A5
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (203) 568-5923

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brendan Stack's NPI number?

The NPI number for Brendan Stack is 1316403892. It was assigned to this individual provider in the NPPES registry on February 20, 2019.

Where is Brendan Stack located?

Brendan Stack practices at 519 Heritage Rd Ste 2a5, Southbury, CT 06488. The listed phone number is (518) 610-4528.

What is Brendan Stack's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Brendan Stack enrolled in Medicare?

Yes. Brendan Stack is registered in the Medicare PECOS enrollment system.

What insurance does Brendan Stack accept?

Health plans from Providence Health Plan list Brendan Stack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brendan Stack was last updated on July 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.