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NPI Code Detail

MEDICARE: STACIE LYNN WHITAKER LPC

MEDICARE: STACIE LYNN WHITAKER LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2012011487MO

General Provider Information

NPI Number : 1306104799
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACIE LYNN WHITAKER LPC
Provider Business Mailing Address
First Line : PO BOX 844715
Second Line :
City : KANSAS CITY
State : MO
Zip : 64184-4715
Country : US
Telephone Number : 417-761-5214
Fax Number : 417-761-5065
Provider Business Practice Location Address
First Line : 900 E LAHARPE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-4520
Country : US
Telephone Number : 660-665-1962
Fax Number : 660-665-3989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2012
Last Update Date : 01/26/2026

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