Provider Demographics
NPI:1073250221
Name:STACY WITZKI CONSULTING, LLC
Entity type:Organization
Organization Name:STACY WITZKI CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WITZKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:816-974-7363
Mailing Address - Street 1:1105 SILVERLEAF LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-8496
Mailing Address - Country:US
Mailing Address - Phone:816-332-7363
Mailing Address - Fax:
Practice Address - Street 1:110 WESTWOODS DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1181
Practice Address - Country:US
Practice Address - Phone:816-974-7363
Practice Address - Fax:816-817-3328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty