Healthcare Provider Details

I. General information

NPI: 1518759588
Provider Name (Legal Business Name): STACEY LYNN HUFF LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 07/19/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 HOLLYWOOD AVE
GAINESVILLE GA
30501-1608
US

IV. Provider business mailing address

1514 HOLLYWOOD AVE
GAINESVILLE GA
30501-1608
US

V. Phone/Fax

Practice location:
  • Phone: 470-768-1610
  • Fax:
Mailing address:
  • Phone: 706-499-3250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015562
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: