Provider Demographics
NPI:1669711966
Name:VANCURA, STACY MARIE (MS LPCC NCC)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:MARIE
Last Name:VANCURA
Suffix:
Gender:F
Credentials:MS LPCC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16204 MN-7
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345
Mailing Address - Country:US
Mailing Address - Phone:320-587-4127
Mailing Address - Fax:320-587-3886
Practice Address - Street 1:902 HIGHWAY 15 S STE 200
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350
Practice Address - Country:US
Practice Address - Phone:320-587-4127
Practice Address - Fax:320-587-3886
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional