Healthcare Provider Details

I. General information

NPI: 1497362826
Provider Name (Legal Business Name): STACEY STAFFORD PHD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14143 DENVER WEST PKWY STE 100
GOLDEN CO
80401-3275
US

IV. Provider business mailing address

6300 WIER WAY
ARVADA CO
80403-7410
US

V. Phone/Fax

Practice location:
  • Phone: 720-608-1440
  • Fax:
Mailing address:
  • Phone: 832-859-2632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.018865
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number100298
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0007196
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number41424
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: