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General NPI Number Information
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NPI Number | 1487489670
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Entity Type | Individual
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Provider Name | KIRSTEN HALEY STACEY LPCC
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Gender |
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 3805 EDWARDS RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45209-1940
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Country | US
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Telephone | 513-808-9226
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Fax |
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Provider Business Mailing Address
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Address Line | 6695 TWINRIDGE LN
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City | CINCINNATI
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State | OH
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Zip | 45224-1754
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Country | US
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Telephone | 937-522-1128
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.2404532
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License Number State | OH
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