Provider Demographics
NPI:1427181122
Name:NEFF, STACY MARIE (MED, LMHC)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:MARIE
Last Name:NEFF
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14805 SE 139TH CT
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-6739
Mailing Address - Country:US
Mailing Address - Phone:425-793-7693
Mailing Address - Fax:
Practice Address - Street 1:12951 BEL RED RD STE 190
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2698
Practice Address - Country:US
Practice Address - Phone:425-462-7662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009942101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health