Provider Demographics
NPI:1750684387
Name:ASAY, STACY L (LMSW, BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:L
Last Name:ASAY
Suffix:
Gender:F
Credentials:LMSW, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 10TH ST
Mailing Address - Street 2:DOWNSTAIRS
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4009
Mailing Address - Country:US
Mailing Address - Phone:917-209-6925
Mailing Address - Fax:
Practice Address - Street 1:1970 52ND STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6323
Practice Address - Country:US
Practice Address - Phone:917-209-6925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11518890103K00000X
NY074863104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker