Provider Demographics
NPI:1003097999
Name:DONEY, STACY ERIN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:ERIN
Last Name:DONEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:STACY
Other - Middle Name:ERIN
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:26 CHESTERS WAY
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-4506
Mailing Address - Country:US
Mailing Address - Phone:443-485-8652
Mailing Address - Fax:
Practice Address - Street 1:26 CHESTERS WAY
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-4506
Practice Address - Country:US
Practice Address - Phone:443-485-8652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00008981041C0700X
MD143461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1003097999Medicaid
DE247242ZDVLMedicare UPIN