Provider Demographics
NPI:1356784862
Name:DOWNEY, STACIA A (PMHNP, MSED, BS, RN)
Entity type:Individual
Prefix:MRS
First Name:STACIA
Middle Name:A
Last Name:DOWNEY
Suffix:
Gender:F
Credentials:PMHNP, MSED, BS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 MCCLELLAN ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-1020
Mailing Address - Country:US
Mailing Address - Phone:518-382-2290
Mailing Address - Fax:518-382-2292
Practice Address - Street 1:624 MCCLELLAN ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1020
Practice Address - Country:US
Practice Address - Phone:518-382-2290
Practice Address - Fax:518-382-2292
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF402479363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health