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General NPI Number Information
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NPI Number | 1346399797
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Entity Type | Individual
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Provider Name | STACEY MAUREEN LAVES-KHALIFA MED
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3400 BISSONNET ST
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City | HOUSTON
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State | TX
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Zip | 77005-2155
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Country | US
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Telephone | 281-793-8716
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Fax |
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Provider Business Mailing Address
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Address Line | 8330 DEBBIE GAY DR
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City | HOUSTON
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State | TX
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Zip | 77040-1502
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Country | US
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Telephone | 281-793-8716
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6327
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10993
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 003603
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License Number State | TX
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