Provider Demographics
NPI:1699450726
Name:GROJEAN, STACIE L (LPC)
Entity type:Individual
Prefix:
First Name:STACIE
Middle Name:L
Last Name:GROJEAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 CHARLESTOWNE PLACE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-4916
Mailing Address - Country:US
Mailing Address - Phone:636-279-0912
Mailing Address - Fax:
Practice Address - Street 1:437 CHARLESTOWNE PLACE DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-4916
Practice Address - Country:US
Practice Address - Phone:636-279-0912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019002274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health