Healthcare Provider Details

I. General information

NPI: 1366218950
Provider Name (Legal Business Name): STACEY EINSTEDER LEE EINSTEDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 HALL ST STE 15
HAYS KS
67601-1964
US

IV. Provider business mailing address

2703 HALL ST STE 15
HAYS KS
67601-1964
US

V. Phone/Fax

Practice location:
  • Phone: 785-261-0694
  • Fax: 785-261-0694
Mailing address:
  • Phone: 785-261-0694
  • Fax: 785-261-0694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLMLP03565-T
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: