Provider Demographics
NPI:1316284631
Name:SANTAMARINA, STACEY BARBARA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:BARBARA
Last Name:SANTAMARINA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 STRENG LN
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-8373
Mailing Address - Country:US
Mailing Address - Phone:561-818-3343
Mailing Address - Fax:
Practice Address - Street 1:1601 BELVEDERE RD # S204
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-1541
Practice Address - Country:US
Practice Address - Phone:561-818-3343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11340101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health