Provider Demographics
NPI:1700989373
Name:STUCKEY, MICHAEL RAY (MS LPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:RAY
Last Name:STUCKEY
Suffix:
Gender:M
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2778
Mailing Address - Street 2:2104 LEIGHTON AVENUE
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202
Mailing Address - Country:US
Mailing Address - Phone:256-236-2246
Mailing Address - Fax:256-237-4353
Practice Address - Street 1:2104 LEIGHTON AVENUE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207
Practice Address - Country:US
Practice Address - Phone:256-236-2246
Practice Address - Fax:256-237-4353
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health