Healthcare Provider Details

I. General information

NPI: 1841716115
Provider Name (Legal Business Name): STACY OXFORD LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 W MAIN ST STE 204
SALISBURY MD
21801-4905
US

IV. Provider business mailing address

116 W MAIN ST STE 204
SALISBURY MD
21801-4905
US

V. Phone/Fax

Practice location:
  • Phone: 443-859-8584
  • Fax: 443-859-8496
Mailing address:
  • Phone: 443-859-8584
  • Fax: 443-859-8496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC8664
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: