Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Brendan Stack, LPC, LADC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1316403892

Mr. Brendan Stack, LPC, LADC is a Mental Health Counselor in Southbury, Connecticut. Qualified in 2018, 8 years ago. Practices with Southbury Adolescent and Young Adult Counseling Center, a 15-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
8
Licensed in
CT
In the registry since
2019
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.
LADC — Licensed Alcohol and Drug Counselor
A licensed addiction counsellor.

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Practice location Address checks out

519 Heritage Rd Ste 2A5
Southbury, CT 06488-6694
Phone: (518) 610-4528
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 4530 (CT)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 001323 (CT)

Record details

NPI number1316403892
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC , LADC
Sole proprietorYes
NPI enumeratedFebruary 20, 2019
Last updated in NPPESJuly 18, 2025
Certification dateJuly 18, 2025
Mailing address127 Watertown Rd, Middlebury, CT 06762-1502

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Southbury Adolescent And Young Adult Counseling Center — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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