NPI Code Details Logo

NPI 1366908188

NPI 1366908188 : MICHAEL STEPHEN STAGAR IV LPC-S, LCDC : KILLEEN, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1366908188
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MICHAEL STEPHEN STAGAR IV LPC-S, LCDC
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/17/2019
-----------------------------------------------------
    Last Update Date     |    12/04/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1519 FLORENCE RD STE 5 
-----------------------------------------------------
    City                 |    KILLEEN
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    76541-7904
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    254-300-7798
-----------------------------------------------------
    Fax                  |    254-300-9938
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1519 FLORENCE RD STE 5 
-----------------------------------------------------
    City                 |    KILLEEN
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    76541-7904
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    254-300-7798
-----------------------------------------------------
    Fax                  |    254-300-9938
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YA0400X
-----------------------------------------------------
    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
    License Number       |    13965
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    101YM0800X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Counselor
-----------------------------------------------------
    License Number       |    76862
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    101YP2500X
-----------------------------------------------------
    Taxonomy Name        |    Professional Counselor
-----------------------------------------------------
    License Number       |    76862
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.