Healthcare Provider Details

I. General information

NPI: 1699200162
Provider Name (Legal Business Name): STACEY LYNN CARABIN APRN-CNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STACEY LYNN CARABIN APRN-CNP, LISW

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 WOODLEY RD
TOLEDO OH
43606-1169
US

IV. Provider business mailing address

3909 WOODLEY RD
TOLEDO OH
43606-1169
US

V. Phone/Fax

Practice location:
  • Phone: 419-725-3330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.2002286
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0031643
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: