Provider Demographics
NPI:1831581255
Name:BRITTAIN, STACEY (LCSW-S)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:BRITTAIN
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:SHULER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6711 STELLA LINK RD # 4662ND
Mailing Address - Street 2:
Mailing Address - City:WEST UNIVERSITY PLACE
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4342
Mailing Address - Country:US
Mailing Address - Phone:281-782-6279
Mailing Address - Fax:832-356-2743
Practice Address - Street 1:1941 EAST RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-6010
Practice Address - Country:US
Practice Address - Phone:713-486-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-22
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX530171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX53017OtherPROFESSIONAL LICENSE
TX345573502Medicaid