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NPI Code Detail

MEDICARE: JAMIE STACY

MEDICARE:   JAMIE  STACY
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
1101Y00000XCounselorP-1579MS

General Provider Information

NPI Number : 1376476135
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE STACY
Provider Business Mailing Address
First Line : 117 NORTHPOINTE DR
Second Line :
City : OXFORD
State : MS
Zip : 38655-7713
Country : US
Telephone Number : 601-624-4680
Fax Number :
Provider Business Practice Location Address
First Line : 1204 OFFICE PARK DR STE D
Second Line :
City : OXFORD
State : MS
Zip : 38655-3597
Country : US
Telephone Number : 601-380-5110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ JAMIE STACY ” Practice Location

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