Provider Demographics
NPI:1821341090
Name:LEE, STACY (LPC-MHSPS, LADAC)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LPC-MHSPS, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 CHENAULT LN
Mailing Address - Street 2:
Mailing Address - City:CASTALIAN SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37031-4773
Mailing Address - Country:US
Mailing Address - Phone:575-430-5990
Mailing Address - Fax:
Practice Address - Street 1:2400 WHITE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2235
Practice Address - Country:US
Practice Address - Phone:888-463-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0154251101YA0400X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)