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Individual
MRS. STACEY LEE ANGUS
Active
Individual
MRS. STACEY LEE ANGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW,CAS, MAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
C-4560
ME
1041C0700X
Clinical Social Worker
Primary
081307
NY
1041C0700X
Clinical Social Worker
LC11436
ME
Other
Enumeration date
07/29/2008
Last updated
11/22/2013
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