Provider Demographics
NPI:1275952095
Name:FLESZAR, STACEY L (MA, LLPC, CAADC)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:L
Last Name:FLESZAR
Suffix:
Gender:F
Credentials:MA, LLPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 PACKARD ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2073
Mailing Address - Country:US
Mailing Address - Phone:734-975-1602
Mailing Address - Fax:
Practice Address - Street 1:3800 PACKARD ST
Practice Address - Street 2:SUITE 210
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-2073
Practice Address - Country:US
Practice Address - Phone:734-975-1602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIC-02720101YA0400X
MI6401012775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)