Roth, Stacey Ann

Roth, Stacey Ann is an sole proprietor health care provider with primary practice located at 5800 Ash Spgs , House Springs MO 63051-3654. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Roth, Stacey Ann can be contacted via phone (314) 971-5797.

Contact Information

Primary practice address
5800 Ash Spgs House Springs MO 63051-3654
Phone: (314) 971-5797
Fax: (636) 323-2250
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2005028635 Missouri
Other Service Providers / Case Manager/Care Coordinator 171M00000X 2005028635 Missouri
Behavioral Health & Social Service Providers / Professional 101YP2500X 2005028635 Missouri

Profile Details

NPI number 1659359800
LBN Legal business name Roth, Stacey Ann
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 6th, 2006
Last updated Jun 5th, 2023 - about 3 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 1659359800 NPPES
Missouri MEDICAID 497513705

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