Provider Demographics
NPI:1962523365
Name:HUNT, STACIE L (LSCSW)
Entity type:Individual
Prefix:
First Name:STACIE
Middle Name:L
Last Name:HUNT
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13117 S TRENTON ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5127
Mailing Address - Country:US
Mailing Address - Phone:913-780-1412
Mailing Address - Fax:913-780-1412
Practice Address - Street 1:13117 S TRENTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5127
Practice Address - Country:US
Practice Address - Phone:913-484-1145
Practice Address - Fax:913-780-1412
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS37071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical