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General NPI Number Information
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NPI Number | 1669154795
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Entity Type | Organization
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Legal Business Name | STACY ENGAGED
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 12233 FORSYTHE DR
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City | AUSTIN
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State | TX
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Zip | 78759-3158
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Country | US
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Telephone | 512-773-1482
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Fax |
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Provider Business Mailing Address
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Address Line | 12233 FORSYTHE DR
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City | AUSTIN
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State | TX
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Zip | 78759-3158
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Country | US
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Telephone | 512-773-1482
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VANESSA BEERS
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Credential |
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Telephone | 512-773-1482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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