Provider Demographics
NPI:1497549950
Name:STACIE STORMER LPCC LLC
Entity type:Organization
Organization Name:STACIE STORMER LPCC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STORMER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:614-285-4886
Mailing Address - Street 1:498 GREENGLADE AVE
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2206
Mailing Address - Country:US
Mailing Address - Phone:614-285-4886
Mailing Address - Fax:614-670-5095
Practice Address - Street 1:1115 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2690
Practice Address - Country:US
Practice Address - Phone:614-285-4886
Practice Address - Fax:614-670-5095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty