Willson, Stacey Grace
Willson, Stacey Grace is an sole proprietor health care provider with primary practice located at 200 N Lakepointe Dr , Lafayette LA 70506-6431. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Willson, Stacey Grace can be contacted via phone (337) 412-8048.Contact Information
Primary practice address
200 N Lakepointe Dr
Lafayette LA 70506-6431
Phone: (337) 412-8048
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 37976 | Texas |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 3156 | Louisiana |
Profile Details
| NPI number | 1134177678 |
|---|---|
| LBN Legal business name | Willson, Stacey Grace |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134177678 | NPPES |
| Texas | Other | 37976 | STATE LICENSE |
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