Individual provider · Type 1 NPI

Brendan Stack, LPC, LADC

Professional Counselor · Southbury, CT

NPI number 1316403892 Active

Practice location

519 Heritage Rd Ste 2A5
Southbury, CT 06488-6694

Mailing address

127 Watertown Rd
Middlebury, CT 06762-1502

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X001323 (CT)
Professional Counselor Primary 101YP2500X4530 (CT)

Professional Counselor: Definition to come...

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About NPI 1316403892

Brendan Stack, LPC, LADC's National Provider Identifier is 1316403892, issued on Feb 20, 2019. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Southbury, CT. The record was last updated on Jul 18, 2025.