Provider Demographics
NPI:1033681887
Name:OGDEN, STACEY (LPC)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:OGDEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 CRICKET DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-1730
Mailing Address - Country:US
Mailing Address - Phone:214-636-0869
Mailing Address - Fax:
Practice Address - Street 1:1420 W MOCKINGBIRD LN STE 105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4936
Practice Address - Country:US
Practice Address - Phone:469-983-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80150101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor