Healthcare Provider Details

I. General information

NPI: 1235886136
Provider Name (Legal Business Name): STACEY MARIE HOPE LCMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 S OAKLAND AVE STE 1214
ROCK HILL SC
29730-6469
US

IV. Provider business mailing address

153 S OAKLAND AVE STE 1214
ROCK HILL SC
29730-6469
US

V. Phone/Fax

Practice location:
  • Phone: 803-524-6810
  • Fax:
Mailing address:
  • Phone: 803-524-6810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number10749
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17397
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17397
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17397
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10749
License Number StateSC
# 6
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10749
License Number StateSC
# 7
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number17397
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: