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

Mr. John Leroy Stacy Jr., CSAC, LPC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1306182795

Mr. John Leroy Stacy Jr., CSAC, LPC is a Mental Health Counselor in Norfolk, Virginia. Qualified in 2012, 14 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
14
Licensed in
VA
In the registry since
2012
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

1216 Granby St Ste 211
Norfolk, VA 23510-2622
Phone: (757) 632-0343
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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 0701006465 (VA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 0710102681 (VA)

Record details

NPI number1306182795
Entity typeIndividual (Type 1)
GenderMale
Credentials CSAC , LPC
Sole proprietorYes
NPI enumeratedDecember 12, 2012
Last updated in NPPESApril 17, 2024
Certification dateApril 17, 2024

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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