MEDICARE: STACIE LYNN LINDSEY LPC - CANDIDATE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPCCANDIDATE13190	OK

General Provider Information

NPI Number	:	1558206656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACIE LYNN LINDSEY LPC - CANDIDATE

Provider Business Mailing Address
First Line	:	6707 E 133RD ST S
Second Line	:
City	:	BIXBY
State	:	OK
Zip	:	74008-3131
Country	:	US
Telephone Number	:	405-818-7780
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 N BROADWAY STE 104
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73034-3642
Country	:	US
Telephone Number	:	405-818-7780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

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