MR. JOHN LEROY STACY CSAC LPC NPI 1306182795

NPI Information

NPI: 1306182795
Provider Name: MR. JOHN LEROY STACY, CSAC, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
1216 GRANBY ST STE 211
NORFOLK, VA
ZIP 23510
Phone: (757) 632-0343
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MR. John Leroy Stacy, CSAC, LPC is a professional counselor in Norfolk, VA. MR. John Leroy Stacy, CSAC, LPC NPI is 1306182795. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1216 GRANBY ST STE 211
NORFOLK, VA
ZIP 23510-622
Phone: (757) 632-0343

The enumeration date for this NPI number is 12/12/2012 and was last updated on 4/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	0710102681	VIRGINIA	No
2	101YP2500X	Counselor	Professional	0701006465	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1245936616	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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