Jacobson-Gray, Stacia

Jacobson-Gray, Stacia is an individual health care provider with primary practice located at 3395 Plymouth Rd , Minnetonka MN 55305-3765. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Jacobson-Gray, Stacia can be contacted via phone (952) 939-0396.

Contact Information

Primary practice address
3395 Plymouth Rd Minnetonka MN 55305-3765
Phone: (952) 939-0396
Fax: (952) 548-8760
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X CC01218 Minnesota

Profile Details

NPI number 1457658981
LBN Legal business name Jacobson-Gray, Stacia
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 18th, 2011
Last updated May 16th, 2016 - about 9 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.

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