Masten, Stacy E

Masten, Stacy E is an sole proprietor health care provider with primary practice located at 804 Ainsworth Dr Ste 105, Prescott AZ 86301-1624. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Masten, Stacy E can be contacted via phone (928) 777-0919.

Contact Information

Primary practice address
804 Ainsworth Dr Ste 105 Prescott AZ 86301-1624
Fax: (928) 777-8897
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCSW3469 Arizona

Profile Details

NPI number 1104829589
LBN Legal business name Masten, Stacy E
Credentials M.S.W., L.C.S.W.
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2005
Last updated Sep 28th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104829589 NPPES
Arizona MEDICAID 748337

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