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NPI Code Detail

MEDICARE: STACEY DAVID-REAY LCSW

MEDICARE: STACEY DAVID-REAY LCSW
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1891840278
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY DAVID-REAY LCSW
Provider Business Mailing Address
First Line : 1941 REBEL RIDGE DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99504-2931
Country : US
Telephone Number : 907-729-4955
Fax Number :
Provider Business Practice Location Address
First Line : 225 EAGLE ST
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-2626
Country : US
Telephone Number : 907-729-6550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 07/08/2007

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Directions to “ STACEY DAVID-REAY LCSW” Practice Location

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