Provider Demographics
NPI:1508010240
Name:GESINGER, STACEY RENEE (MA, LMFT ASSOCIATE)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:RENEE
Last Name:GESINGER
Suffix:
Gender:F
Credentials:MA, LMFT ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11413 ARCHSTONE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-1907
Mailing Address - Country:US
Mailing Address - Phone:512-529-7662
Mailing Address - Fax:
Practice Address - Street 1:3870 FM 967
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-9742
Practice Address - Country:US
Practice Address - Phone:512-529-7662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201326106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist