Provider Demographics
NPI:1043322381
Name:HUBBARD, STACY (LMFT)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 QUAIL RUN RD
Mailing Address - Street 2:
Mailing Address - City:TALENT
Mailing Address - State:OR
Mailing Address - Zip Code:97540-6730
Mailing Address - Country:US
Mailing Address - Phone:541-778-5987
Mailing Address - Fax:
Practice Address - Street 1:2775 QUAIL RUN RD
Practice Address - Street 2:
Practice Address - City:TALENT
Practice Address - State:OR
Practice Address - Zip Code:97540-6730
Practice Address - Country:US
Practice Address - Phone:541-778-5987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health