Provider Demographics
NPI:1770726085
Name:PLATE, STACEY (PLPC)
Entity type:Individual
Prefix:MS
First Name:STACEY
Middle Name:
Last Name:PLATE
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 SAINT CHARLES ROCK RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-4508
Mailing Address - Country:US
Mailing Address - Phone:314-427-3755
Mailing Address - Fax:314-426-0764
Practice Address - Street 1:8240 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-4508
Practice Address - Country:US
Practice Address - Phone:314-427-3755
Practice Address - Fax:314-426-0764
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-16
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009007204101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health