Provider Demographics
NPI:1831535723
Name:CROSSON, STACEY TASLER (LMFT)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:TASLER
Last Name:CROSSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:KELLERSKOPFSTR. 15A
Mailing Address - Street 2:
Mailing Address - City:TAUNUSSTEIN
Mailing Address - State:HESSEN
Mailing Address - Zip Code:65232
Mailing Address - Country:DE
Mailing Address - Phone:01512-264-9476
Mailing Address - Fax:
Practice Address - Street 1:CMR 467 BOX 3504
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09096-0036
Practice Address - Country:US
Practice Address - Phone:01512-264-9476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist