Provider Demographics
NPI:1609919000
Name:STUCKEY, AKIRA (MA, LCMHC)
Entity Type:Individual
Prefix:
First Name:AKIRA
Middle Name:
Last Name:STUCKEY
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 WEST ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3359
Mailing Address - Country:US
Mailing Address - Phone:603-721-1641
Mailing Address - Fax:
Practice Address - Street 1:151 WEST ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3359
Practice Address - Country:US
Practice Address - Phone:603-721-1641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH870101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health