Provider Demographics
NPI:1669954962
Name:BARNES, STACY (LPC, LCDC-I)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:BARNES
Suffix:
Gender:F
Credentials:LPC, LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 GREY FOX DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TX
Mailing Address - Zip Code:76227-7775
Mailing Address - Country:US
Mailing Address - Phone:214-405-0537
Mailing Address - Fax:
Practice Address - Street 1:4300 COMMUNITY AVE
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-2535
Practice Address - Country:US
Practice Address - Phone:725-475-2909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72345101YM0800X
TX101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)