Wood, Stacy Rae

Wood, Stacy Rae is an individual health care provider with primary practice located at 801 W Richards St , Douglas WY 82633-8931. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / School is her primary health care specialty. Wood, Stacy Rae can be contacted via phone (307) 358-9771.

Contact Information

Primary practice address
801 W Richards St Douglas WY 82633-8931
Phone: (307) 358-9771
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC-1878 Wyoming
Behavioral Health & Social Service Providers / School 101YS0200X 61341 Wyoming

Profile Details

NPI number 1558007682
LBN Legal business name Wood, Stacy Rae
Credentials LPC, CRC
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2022
Last updated Sep 28th, 2022 - 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 1558007682 NPPES
Wyoming Other LPC-1878 MENTAL HEALTH PROFESSIONS LICENSING BOARD
Wyoming Other 61341 MENTAL HEALTH PROFESSIONS LICENSING BOARD

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