Provider Demographics
NPI:1033669429
Name:MAYS, STACY (LMSW)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:
Last Name:MAYS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SE GRAND AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-2857
Mailing Address - Country:US
Mailing Address - Phone:816-581-3737
Mailing Address - Fax:
Practice Address - Street 1:211 SE GRAND AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-2857
Practice Address - Country:US
Practice Address - Phone:816-581-3737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW102071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical