Provider Demographics
NPI:1972308286
Name:GASPARD, STACEY (MA, LPC)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:GASPARD
Suffix:
Gender:
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WEST PASADENA BLVD
Mailing Address - Street 2:#624
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536
Mailing Address - Country:US
Mailing Address - Phone:832-890-8880
Mailing Address - Fax:
Practice Address - Street 1:401 WEST PASADENA BLVD
Practice Address - Street 2:#624
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-7753
Practice Address - Country:US
Practice Address - Phone:832-890-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health