MR. BRENDAN STACK LPC, LADC
NPI 1316403892
Counselor - Professional in Southbury, CT
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
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Brendan Stack Lpc, Ladc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Brendan Stack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Southbury, CT 06488
- Reassigned Medicare billing, Connecticut enrollment
- 24 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTHBURY, CT 06488
SOUTHBURY, CT 06488
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 system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Brendan Stack's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brendan Stack reassigns Medicare benefits to Southbury Adolescent And Young Adult Counseling Center (Southbury, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Brendan Stack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Brendan Stack accept?
Health plans from Anthem Blue Cross and Blue Shield 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 15 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.
# Mr. Brendan Stack, LPC, LADC · NPI 1316403892
Professional provider in Southbury, Connecticut. Individual provider, active in the CMS NPPES registry since February 20, 2019.
## Identity
- **NPI:** 1316403892 (Entity type: Individual)
- **Enumerated:** February 20, 2019
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** 4530 (Connecticut)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 519 HERITAGE RD STE 2A5, Southbury, CT 06488-6694
- **Phone:** (518) 610-4528
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Southbury Adolescent And Young Adult Counseling Center (NPI 1235737735, Southbury, CT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** July 18, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1316403892) · Data from the CMS NPPES public registry.