Provider Demographics
NPI:1518406115
Name:ROWLAND, STACEY PULESKI (LPC)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:PULESKI
Last Name:ROWLAND
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 1:5202 E JANICE WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2337
Mailing Address - Country:US
Mailing Address - Phone:602-525-6049
Mailing Address - Fax:
Practice Address - Street 1:1130 E MISSOURI AVE STE 700
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2717
Practice Address - Country:US
Practice Address - Phone:602-525-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15738101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional