Provider Demographics
NPI:1114046000
Name:HUEY, STACEY JANNETTE (MED, BA)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:JANNETTE
Last Name:HUEY
Suffix:
Gender:F
Credentials:MED, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-6604
Mailing Address - Country:US
Mailing Address - Phone:931-359-3013
Mailing Address - Fax:931-359-3013
Practice Address - Street 1:1450 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-6604
Practice Address - Country:US
Practice Address - Phone:931-359-3013
Practice Address - Fax:931-359-3013
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health