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General NPI Number Information
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NPI Number | 1730542499
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Entity Type | Organization
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Legal Business Name | STACY A. STEIN, LCPC, LLC
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Dates
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Enumeration Date | 03/31/2016
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 111 E CHURCH ST
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City | MASCOUTAH
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State | IL
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Zip | 62258-2110
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Country | US
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Telephone | 618-566-3100
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Fax | 618-551-2233
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Provider Business Mailing Address
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Address Line | 111 E CHURCH ST
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City | MASCOUTAH
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State | IL
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Zip | 62258-2110
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Country | US
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Telephone | 618-566-3100
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Fax | 618-551-2233
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Authorized Official
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Title or Position | OWNER/ LCPC
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Name | MRS. STACY STEIN
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Credential |
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Telephone | 618-566-3100
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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 | 180010102
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License Number State | IL
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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 | 180006373
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License Number State | IL
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