Provider Demographics
NPI:1609761352
Name:HOVIS, STACEY
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:HOVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 PATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-4318
Mailing Address - Country:US
Mailing Address - Phone:402-403-7905
Mailing Address - Fax:
Practice Address - Street 1:2516 PATRICK AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-4318
Practice Address - Country:US
Practice Address - Phone:531-867-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth ServiceGroup - Single Specialty