Provider Demographics
NPI:1366908188
Name:STAGAR, MICHAEL STEPHEN IV (LPC-S, LCDC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEPHEN
Last Name:STAGAR
Suffix:IV
Gender:M
Credentials:LPC-S, LCDC
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:STEPHEN
Other - Last Name:STAGAR
Other - Suffix:IV
Other - Last Name Type:Professional Name
Other - Credentials:LPC-S, LCDC
Mailing Address - Street 1:1519 FLORENCE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-7904
Mailing Address - Country:US
Mailing Address - Phone:254-300-7798
Mailing Address - Fax:254-300-9938
Practice Address - Street 1:1519 FLORENCE RD STE 5
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-7904
Practice Address - Country:US
Practice Address - Phone:254-300-7798
Practice Address - Fax:254-300-9938
Is Sole Proprietor?:No
Enumeration Date:2019-02-17
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13965101YA0400X
TX76862101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health