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STACY KATHRYN MUTRYNOWSKI LMFT
NPI 1831614866
Marriage & Family Therapist in San Leandro, CA

Active since August 10, 2017PECOS Enrolled
2401 MERCED ST, SAN LEANDRO, CA 94577(510) 362-3553(510) 618-5830 Get Directions Write a Review

NPPES record last updated: October 31, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 31, 2022, Oct 27, 2022, Jan 29, 2019 and 1 more (4 updates tracked since 2017).

About Stacy Kathryn Mutrynowski Lmft NPPES

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

STACY KATHRYN MUTRYNOWSKI LMFT (NPI 1831614866) is an individual marriage & family therapist in San Leandro, California, licensed in California (130363) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1831614866
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameSTACY KATHRYN MUTRYNOWSKICredential: LMFT
Location Address2401 MERCED STSan Leandro, CA 94577-4228
Mailing Address1025 Adason DrSan Leandro, CA 94578-3613 · (818) 613-3394
Phone(510) 362-3553
Fax(510) 618-5830
Sole ProprietorNo
Enumeration DateAugust 10, 2017
Last NPPES UpdateOctober 31, 20224 updates tracked since enumeration
NPPES CertifiedOctober 31, 2022
✔ NPI 1831614866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
Licenses✔ Licensed in CA · 130363✔ Licensed in CA · 108812
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
2401 MERCED ST, San Leandro, CA 94577
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacy Kathryn Mutrynowski Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 19

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

LAYLA GHAZZAGH LCSW
Social Worker (Clinical)
2401 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 618-5990
CORA TAYLOR M.F.T.
Marriage & Family Therapist
2401 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (999) 999-9999
MISS THANH PHUONG LE LCSW
Social Worker (Clinical)
2401 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 618-5969
GENNIFER UNELL PHARMD
Pharmacist (Ambulatory Care)
2401 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 675-5781
SATELLITE DIALYSIS OF WEST SAN LEANDRO LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
2401 MERCED ST, SUITE 110
SAN LEANDRO, CA 94577
Alameda County (510) 746-3900
COURTNEY NICOLE ROGACHEVSKY LCSW
Social Worker (Clinical)
2401 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (323) 441-6177
MANOLO CARANDANG ASEREMO
Registered Nurse (Hemodialysis)
2401 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 746-3900
JESENIA JANETH GIL LCSW
Social Worker (Clinical)
2401 MERCED ST
SAN LEANDRO, CA 94577
Alameda County (510) 203-2163

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 Stacy Mutrynowski's NPI number?

The NPI number for Stacy Mutrynowski is 1831614866. It was assigned to this individual provider in the NPPES registry on August 10, 2017.

Where is Stacy Mutrynowski located?

Stacy Mutrynowski practices at 2401 Merced St, San Leandro, CA 94577. The listed phone number is (510) 362-3553.

What is Stacy Mutrynowski's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Stacy Mutrynowski enrolled in Medicare?

Yes. Stacy Mutrynowski is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Stacy Mutrynowski was last updated on October 31, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.