Provider Demographics
NPI:1790421386
Name:CARTEE, STACEY LYN (MED, CSOTP)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:LYN
Last Name:CARTEE
Suffix:
Gender:F
Credentials:MED, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 HOPETOWN RD APT J6
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8875
Mailing Address - Country:US
Mailing Address - Phone:740-701-8326
Mailing Address - Fax:740-721-4155
Practice Address - Street 1:382 ARCH ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-1518
Practice Address - Country:US
Practice Address - Phone:740-804-6800
Practice Address - Fax:740-721-4155
Is Sole Proprietor?:No
Enumeration Date:2022-05-07
Last Update Date:2022-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH254837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health