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General NPI Number Information
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NPI Number | 1538350350
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Entity Type | Individual
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Provider Name | STACEY L. FARRADAY LPCMH
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Gender | Female
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/10/2025
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Provider Practice Location Address
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Address Line | 110 OLIVINE CIR
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City | TOWNSEND
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State | DE
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Zip | 19734-2001
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Country | US
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Telephone | 302-373-8005
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Fax | 888-830-5523
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Provider Business Mailing Address
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Address Line | 110 OLIVINE CIR
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City | TOWNSEND
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State | DE
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Zip | 19734-2001
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Country | US
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Telephone | 302-373-8005
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Fax | 888-830-5523
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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 | PC-0000414
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC-0000414
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License Number State | DE
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