Provider Demographics
NPI:1801953732
Name:CONNER, STACEY DIAN (LPC-S)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:DIAN
Last Name:CONNER
Suffix:
Gender:
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3802 SPRINGCREST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-4529
Mailing Address - Country:US
Mailing Address - Phone:830-220-7377
Mailing Address - Fax:
Practice Address - Street 1:3802 SPRINGCREST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-4529
Practice Address - Country:US
Practice Address - Phone:830-220-7377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81674101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional