Healthcare Provider Details

I. General information

NPI: 1902553811
Provider Name (Legal Business Name): STACEY SEAY LPC LSOTP LCDC NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 SUGAR CREEK CENTER BLVD STE 460
SUGAR LAND TX
77478-3786
US

IV. Provider business mailing address

3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US

V. Phone/Fax

Practice location:
  • Phone: 855-501-1004
  • Fax:
Mailing address:
  • Phone: 855-501-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number74312
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: