Provider Demographics
NPI:1831323658
Name:NUAR, STACY COLLEEN (MA, LLP)
Entity Type:Individual
Prefix:MS
First Name:STACY
Middle Name:COLLEEN
Last Name:NUAR
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:COLLEEN
Other - Last Name:FAIRCHILD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LLP
Mailing Address - Street 1:7560 GLASCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-1333
Mailing Address - Country:US
Mailing Address - Phone:248-330-0748
Mailing Address - Fax:
Practice Address - Street 1:905 S CENTER ST
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3230
Practice Address - Country:US
Practice Address - Phone:248-330-0748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1831323658103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist