Provider Demographics
NPI:1982900593
Name:STACY TEMPLETON DAVIS PSYD LLC
Entity type:Organization
Organization Name:STACY TEMPLETON DAVIS PSYD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:TEMPLETON
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, MP
Authorized Official - Phone:337-593-0830
Mailing Address - Street 1:2020 W PINHOOK RD STE 504
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3212
Mailing Address - Country:US
Mailing Address - Phone:337-593-0830
Mailing Address - Fax:
Practice Address - Street 1:2020 W PINHOOK RD STE 504
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3212
Practice Address - Country:US
Practice Address - Phone:337-593-0830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty