Roth, Stacey Ann
Roth, Stacey Ann is an sole proprietor health care provider with primary practice located at 5800 Ash Spgs , House Springs MO 63051-3654. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Roth, Stacey Ann can be contacted via phone (314) 971-5797.Contact Information
Primary practice address
5800 Ash Spgs
House Springs MO 63051-3654
Phone: (314) 971-5797
Fax: (636) 323-2250
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 2005028635 | Missouri |
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | 2005028635 | Missouri |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 2005028635 | Missouri |
Profile Details
| NPI number | 1659359800 |
|---|---|
| LBN Legal business name | Roth, Stacey Ann |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 6th, 2006 |
| Last updated | Jun 5th, 2023 - about 2 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 | 1659359800 | NPPES |
| Missouri | MEDICAID | 497513705 |
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