Provider Demographics
NPI:1114267911
Name:POSEY, STACEY HOUSE
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:HOUSE
Last Name:POSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 LANCE WAY
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-2643
Mailing Address - Country:US
Mailing Address - Phone:757-952-7407
Mailing Address - Fax:757-223-1203
Practice Address - Street 1:119 LANCE WAY
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-2643
Practice Address - Country:US
Practice Address - Phone:757-952-7407
Practice Address - Fax:757-223-1203
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA222Q00000XMedicaid