Provider Demographics
NPI:1346573003
Name:STABLEY, JAMIE L (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:L
Last Name:STABLEY
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 1:6456 E HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-2926
Mailing Address - Country:US
Mailing Address - Phone:480-325-5015
Mailing Address - Fax:480-832-0611
Practice Address - Street 1:4115 E VALLEY AUTO DR
Practice Address - Street 2:203
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4606
Practice Address - Country:US
Practice Address - Phone:480-507-7880
Practice Address - Fax:480-507-8013
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10839101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional