Provider Demographics
NPI:1164479549
Name:ALBARRAN, STACY L (LISW-CP, LMFT, LPC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:L
Last Name:ALBARRAN
Suffix:
Gender:F
Credentials:LISW-CP, LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 MERWETHER LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7908
Mailing Address - Country:US
Mailing Address - Phone:843-670-9872
Mailing Address - Fax:
Practice Address - Street 1:2741 MERWETHER LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7908
Practice Address - Country:US
Practice Address - Phone:843-670-9872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLPC #2567101YM0800X
SCLMSW #1119104100000X
SCLMFT #2295106H00000X
SC11191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist