Provider Demographics
NPI:1851693253
Name:JOSLYN, STACY (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:
Last Name:JOSLYN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19801 W 97TH ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-3351
Mailing Address - Country:US
Mailing Address - Phone:913-322-1626
Mailing Address - Fax:
Practice Address - Street 1:19801 W 97TH ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66220-3351
Practice Address - Country:US
Practice Address - Phone:913-322-1626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7949104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker