Provider Demographics
NPI:1538430004
Name:GARCIA, STACY LYNN (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:LYNN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:LYNN
Other - Last Name:REEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC, NCC
Mailing Address - Street 1:235 HIGH ST STE 810
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-5448
Mailing Address - Country:US
Mailing Address - Phone:304-685-1312
Mailing Address - Fax:
Practice Address - Street 1:235 HIGH ST STE 810
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-5448
Practice Address - Country:US
Practice Address - Phone:304-685-1312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV90481101YM0800X
WV2040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health