Provider Demographics
NPI:1114011855
Name:CARD, STACY L (LMHC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:L
Last Name:CARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 N NEVADA ST
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-3111
Mailing Address - Country:US
Mailing Address - Phone:509-467-7913
Mailing Address - Fax:509-467-0344
Practice Address - Street 1:10220 N NEVADA ST
Practice Address - Street 2:SUITE 280
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-3111
Practice Address - Country:US
Practice Address - Phone:509-467-7913
Practice Address - Fax:509-467-0344
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010497101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health