Provider Demographics
NPI:1659406635
Name:HERREID-HALSTEAD, STACEY (BS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:
Last Name:HERREID-HALSTEAD
Suffix:
Gender:F
Credentials:BS, LPC
Other - Prefix:MISS
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:HERREID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:144 BERKELEY RD
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-3302
Mailing Address - Country:US
Mailing Address - Phone:215-718-7974
Mailing Address - Fax:
Practice Address - Street 1:2 HIDDEN LN
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-4603
Practice Address - Country:US
Practice Address - Phone:267-209-0449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016495101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional