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

Stacy Anne Kidwell

Individual provider Behavior Technician · NPI 1114573912

Stacy Anne Kidwell is a Mental Health Counselor in Coral Springs, Florida. Qualified in 2019, 7 years ago. Practices with Shardae Tripp Counseling LLC, a 12-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2019
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3325 N University Dr
Coral Springs, FL 33065-4162
Phone: (954) 344-6550
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3491 Gandy Blvd N Ste 201, Pinellas Park, FL 33781-2654 — (727) 547-0607

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence MH23267 (FL)
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1114573912
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 16, 2019
Last updated in NPPESJune 27, 2024
Certification dateJuly 15, 2022

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Shardae Tripp Counseling Llc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Coral Springs