Provider Demographics
NPI:1831752237
Name:GUTHRIE, STACEY L (LPC/MHSP, NCC, ACS)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:L
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:LPC/MHSP, NCC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:DANDRIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37725-4749
Mailing Address - Country:US
Mailing Address - Phone:865-940-1530
Mailing Address - Fax:
Practice Address - Street 1:1232 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725-4749
Practice Address - Country:US
Practice Address - Phone:865-940-1530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-21
Last Update Date:2019-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health