Provider Demographics
NPI:1982932521
Name:BARTLEBAUGH, STACY SUE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:SUE
Last Name:BARTLEBAUGH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 OLD ROUTE 36
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-8269
Mailing Address - Country:US
Mailing Address - Phone:814-673-7803
Mailing Address - Fax:
Practice Address - Street 1:44 OLD ROUTE 36
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-8269
Practice Address - Country:US
Practice Address - Phone:814-673-7803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005283101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional