Provider Demographics
NPI:1922269059
Name:LOUK, STACY ANN (LCPC, NCC, LMHC)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:ANN
Last Name:LOUK
Suffix:
Gender:F
Credentials:LCPC, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-4304
Mailing Address - Country:US
Mailing Address - Phone:941-312-6412
Mailing Address - Fax:941-806-0447
Practice Address - Street 1:2014 4TH ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-4304
Practice Address - Country:US
Practice Address - Phone:941-312-6412
Practice Address - Fax:941-806-0447
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1486101YM0800X
FLMH9651101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health