Provider Demographics
NPI:1194150706
Name:HARCUS, STACIE ALLEEN (MS, LMHC)
Entity type:Individual
Prefix:
First Name:STACIE
Middle Name:ALLEEN
Last Name:HARCUS
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6041 17TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-1466
Mailing Address - Country:US
Mailing Address - Phone:775-830-0349
Mailing Address - Fax:
Practice Address - Street 1:3400 HARBOR AVE SW STE 409
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-2398
Practice Address - Country:US
Practice Address - Phone:775-830-0349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60957136101YM0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program