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General NPI Number Information
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NPI Number | 1083948533
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Entity Type | Organization
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Legal Business Name | DR STACEY A HANCOCK LLC
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 11925 PEARL RD STE 306A
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City | STRONGSVILLE
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State | OH
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Zip | 44136-3343
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Country | US
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Telephone | 440-554-5661
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Fax | 330-776-5557
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Provider Business Mailing Address
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Address Line | PO BOX 5254
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City | POLAND
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State | OH
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Zip | 44514-0254
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Country | US
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Telephone | 330-520-2221
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Fax | 330-776-5557
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Authorized Official
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Title or Position | PRESIDENT
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Name | STACEY A HANCOCK
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Credential | PSY.D
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Telephone | 440-554-5661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6098
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License Number State | OH
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