Provider Demographics
NPI:1396376760
Name:APPIAH-OPOKU, STACEY (LPC)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:APPIAH-OPOKU
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 1:1644 54TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-1469
Mailing Address - Country:US
Mailing Address - Phone:205-239-3315
Mailing Address - Fax:
Practice Address - Street 1:12720 HILLCREST RD STE 106
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-7121
Practice Address - Country:US
Practice Address - Phone:469-275-1548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional