Provider Demographics
NPI:1437527611
Name:PARMER, STACY (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:PARMER
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:NORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 E BRADFORD PKWY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4264
Mailing Address - Country:US
Mailing Address - Phone:417-761-5000
Mailing Address - Fax:417-761-5111
Practice Address - Street 1:3401 BERRYWOOD DR STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201
Practice Address - Country:US
Practice Address - Phone:417-761-5000
Practice Address - Fax:417-761-5111
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013014382101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1437527611Medicaid
13617827OtherCAQH