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
Phone: (928) 777-0919
Fax: (928) 777-8897
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1104829589 | NPPES |
Arizona | MEDICAID | 748337 |
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