Provider Demographics
NPI:1093159261
Name:SCHNELL, STACI LEE (MS, CS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:STACI
Middle Name:LEE
Last Name:SCHNELL
Suffix:
Gender:F
Credentials:MS, CS, LMFT
Other - Prefix:
Other - First Name:STACI
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11011 SHERIDAN ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-1505
Mailing Address - Country:US
Mailing Address - Phone:954-951-2929
Mailing Address - Fax:954-252-3767
Practice Address - Street 1:12323 SW 55TH ST
Practice Address - Street 2:SUITE 1003
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33330-3312
Practice Address - Country:US
Practice Address - Phone:954-680-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2779106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist