Provider Demographics
NPI:1609188127
Name:MAY, STACY LYN (MA, LLPC)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LYN
Last Name:MAY
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1004
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-5004
Mailing Address - Country:US
Mailing Address - Phone:810-667-4111
Mailing Address - Fax:810-667-4111
Practice Address - Street 1:1134 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-3042
Practice Address - Country:US
Practice Address - Phone:810-667-4111
Practice Address - Fax:810-667-4111
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1828677101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional