Provider Demographics
NPI:1043198435
Name:MEANS, STACY LEEANN (RBT)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:LEEANN
Last Name:MEANS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 COUNTY ROAD 476
Mailing Address - Street 2:
Mailing Address - City:PALACIOS
Mailing Address - State:TX
Mailing Address - Zip Code:77465-1615
Mailing Address - Country:US
Mailing Address - Phone:979-479-8613
Mailing Address - Fax:
Practice Address - Street 1:17507 STERLING STONE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-2765
Practice Address - Country:US
Practice Address - Phone:979-479-8613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-20-140771106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician