Landrie, Stacey Michelle

Landrie, Stacey Michelle is an sole proprietor health care provider with primary practice located at 828 Airpax Rd Ste 300 , Cambridge MD 21613-6401. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Residential Treatment Facilities / Substance Abuse Rehabilitation Facility. Residential Treatment Facilities / Substance Abuse Rehabilitation Facility is her primary health care specialty. Landrie, Stacey Michelle can be contacted via phone (410) 901-1333.

Contact Information

Primary practice address
828 Airpax Rd Ste 300 Cambridge MD 21613-6401
Phone: (410) 901-1333
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X

Profile Details

NPI number 1972081842
LBN Legal business name Landrie, Stacey Michelle
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2018
Last updated Aug 2nd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972081842 NPPES
Maryland MEDICAID 1770906901

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