Stacy Dahlke, LPC is a medicare enrolled "Counselor - Professional" provider in Fox Lake, Wisconsin. She graduated from healthcare school in 2024 and has 2 years of diverse experience with area of expertise as Mental Health Counselor. Her current practice location is
W10771 Howard Dr W, Fox Lake, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 382-1541.
Stacy Dahlke is licensed to practice in Wisconsin (license number 12161-125) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1609692003.
Healthcare Provider's Profile
| Full Name | Stacy Dahlke |
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| Gender | Female |
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| Speciality | Mental Health Counselor |
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| Experience | 2 Years |
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| Location | W10771 Howard Dr W, Fox Lake, Wisconsin |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Stacy Dahlke graduated from medical school in 2024
NPI Data:
- NPI Number: 1609692003
- Provider Enumeration Date: 12/02/2024
- Last Update Date: 11/13/2025
Medicare PECOS Information:
- PECOS PAC ID: 4981196870
- Enrollment ID: I20251128000280
Medical Identifiers
Medical identifiers for Stacy Dahlke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609692003 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YP2500X | Counselor - Professional | 12161-125 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Stacy Dahlke allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group PA |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245845932
PECOS PAC ID: 3476961368
Enrollment ID: O20221227001453 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacy Dahlke is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Stacy Dahlke, LPC
W10771 Howard Dr W,
Fox Lake, WI 53933-9710
Ph: (920) 382-1541 | Stacy Dahlke, LPC
W10771 Howard Dr W,
Fox Lake, WI 53933-9710
Ph: (920) 382-1541 |
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