Provider Demographics
NPI:1275938524
Name:FARLEY, STACI MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:MARIE
Last Name:FARLEY
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 1:14524 LOGAN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-2720
Mailing Address - Country:US
Mailing Address - Phone:972-589-7608
Mailing Address - Fax:
Practice Address - Street 1:2099 N COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2698
Practice Address - Country:US
Practice Address - Phone:972-437-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70139101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional