Provider Demographics
NPI:1851636922
Name:NAGLE, STACEY (LMHC)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:NAGLE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 EVANSTON AVE N
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8626
Mailing Address - Country:US
Mailing Address - Phone:206-302-8448
Mailing Address - Fax:
Practice Address - Street 1:3417 EVANSTON AVE N
Practice Address - Street 2:SUITE 315
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8626
Practice Address - Country:US
Practice Address - Phone:206-302-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2016-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60692965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health