P Praxis·MD
● Active Type 1 · Individual

DR. Mardi Stacy, PH.D.

Psychologist·Boise, ID· NPI 1417025974 · Enumerated 2006 · 19 years on NPI
Stacy is 1 of 97 psychologist providers in Boise and 1 of 235 in Idaho.
NPI age
19 years
Enumerated 2006-12-01
Primary specialty
Psychologist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-07-08
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 235 active psychologist providers in Idaho.

NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
1 state
17% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-12Enumerated in NPPES
2006 2026

Where they practice

Practice location
1718 W Jefferson St
Boise, ID 837023949
📞 2084248130fax 2084248137
Mailing address
1718 W Jefferson St
Boise, ID 837023949
📞 2084248130fax 2084248137

Specialties

  • Psychologist Primary
    A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a...
    ID license #PSY-429 taxonomy 103TC0700X

Practice context

Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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