Provider Demographics
NPI:1588987754
Name:COMPTON, STACEE RAENA (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:STACEE
Middle Name:RAENA
Last Name:COMPTON
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S SYCAMORE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-3711
Mailing Address - Country:US
Mailing Address - Phone:605-496-3515
Mailing Address - Fax:605-271-4155
Practice Address - Street 1:1500 S SYCAMORE AVE STE 200
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-3711
Practice Address - Country:US
Practice Address - Phone:605-360-6903
Practice Address - Fax:605-271-4155
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2022-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC7097101Y00000X
SDLPC-MH30787101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor