Provider Demographics
NPI:1578982484
Name:STAHL, VICKY SUE (LPC/I)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:SUE
Last Name:STAHL
Suffix:
Gender:F
Credentials:LPC/I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-3764
Mailing Address - Country:US
Mailing Address - Phone:843-899-4949
Mailing Address - Fax:843-899-7224
Practice Address - Street 1:117 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3764
Practice Address - Country:US
Practice Address - Phone:843-899-4949
Practice Address - Fax:843-899-7224
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional