Gedeon, Stacey R
Gedeon, Stacey R is an individual health care provider with primary practice located at 9249 W Lake City Rd , Houghton Lake MI 48629-9602. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gedeon, Stacey R can be contacted via phone (989) 422-5122.Contact Information
Primary practice address
9249 W Lake City Rd
Houghton Lake MI 48629-9602
Phone: (989) 422-5122
Fax: (989) 422-4378
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301010429 | Michigan |
Profile Details
| NPI number | 1336172485 |
|---|---|
| LBN Legal business name | Gedeon, Stacey R |
| Credentials | PSYD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2006 |
| Last updated | Oct 15th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336172485 | NPPES |
| Michigan | Other | G27604070 | MEDICARE PTAN |
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