Provider Demographics
NPI:1447021357
Name:BYERS, STACEY L (LPC)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:L
Last Name:BYERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6635 W HAPPY VALLEY RD STE A104-621
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-2609
Mailing Address - Country:US
Mailing Address - Phone:602-358-7073
Mailing Address - Fax:888-927-0409
Practice Address - Street 1:5932 W MEADOWBROOK AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-2122
Practice Address - Country:US
Practice Address - Phone:623-231-4987
Practice Address - Fax:888-927-0409
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-22478101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional