Provider Demographics
NPI:1194473447
Name:HOPKINS, STACIE CHARISE (LPC)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:CHARISE
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 ROYAL CHARTRES SQ W APT 304
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4470
Mailing Address - Country:US
Mailing Address - Phone:708-829-1471
Mailing Address - Fax:
Practice Address - Street 1:8134 COUNTRY VILLAGE DR STE 102
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-2095
Practice Address - Country:US
Practice Address - Phone:901-682-6136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5807101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional