Provider Demographics
NPI:1710114491
Name:MONAGHAN, STACY LYNN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LYNN
Last Name:MONAGHAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:STACY
Other - Middle Name:LYNN
Other - Last Name:KIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:23550 LYONS AVENUE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321
Mailing Address - Country:US
Mailing Address - Phone:661-255-5660
Mailing Address - Fax:
Practice Address - Street 1:23550 LYONS AVENUE
Practice Address - Street 2:SUITE 211
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321
Practice Address - Country:US
Practice Address - Phone:661-255-5660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43990106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist