Provider Demographics
NPI:1275912016
Name:HUBLEY, STACY (MS LPC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:HUBLEY
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 TOWER PL
Mailing Address - Street 2:
Mailing Address - City:FOX RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60021-1878
Mailing Address - Country:US
Mailing Address - Phone:847-528-2060
Mailing Address - Fax:
Practice Address - Street 1:3510 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:JOHNSBURG
Practice Address - State:IL
Practice Address - Zip Code:60051-2506
Practice Address - Country:US
Practice Address - Phone:877-375-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-26
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.006511101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor