STACY L FAHLSING (DR.) – Psychologist, NPI 1457416158

STACY L FAHLSING (DR.) is a healthcare provider. based in Lima, Ohio. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials DR.. They hold a License No. 5830 (OH). The NPI Number for STACY L FAHLSING (DR.) is 1457416158

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
STACY L FAHLSING (DR.)
NPI
1457416158
Phone
(419) 999-2024
Address
3611 S DIXIE HWY
Enumeration Date
25 December 2006
Last Update Date
19 November 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4199992024
Graduation Year
1998 (28 years ago)
PAC ID
5890719991
Group Practice PAC ID
6800810904
Professional Enrollment ID
I20120130000213
Address ID
OH458061662LI3745XRDXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,139 CLINICAL PSYCHOLOGIST in OH

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Provider Addresses for STACY L FAHLSING (DR.)

  • South Dixie Highway, Fort Shawnee, Shawnee Township, Allen County, Ohio, 45806, United States

    LIMA, OH 458043750

    Phone: (419) 999-2024

    Type: Mailing

  • Shawnee Road, Lima, Shawnee Township, Allen County, Ohio, 45805, United States

    LIMA, OH 458061662

    Phone: (419) 999-2024

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-01-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120130000213IClinical PsychologistOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45804)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800810904View full group profile
NameSpecialtyState
Clinical Social WorkerOH

Reviews

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Frequently asked questions

Can I cross-check STACY L FAHLSING (DR.) using NPI 1457416158?
NPI 1457416158 belongs to STACY L FAHLSING (DR.); compare other details if you need extra assurance.
Is STACY L FAHLSING (DR.) shown as active in public data?
Registry records indicate STACY L FAHLSING (DR.) maintains an active NPI.
What area of care is associated with STACY L FAHLSING (DR.)?
STACY L FAHLSING (DR.)'s record emphasizes Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with STACY L FAHLSING (DR.)?
Directory geography for STACY L FAHLSING (DR.) centers on Lima, Ohio.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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