Individual
STACY HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLMPH, PLCSW
Contact information
Practice address
7552 S 84TH ST, LA VISTA, NE 68128-2424
(402) 213-5174
Mailing address
7552 S 84TH ST, LA VISTA, NE 68128-2424
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
12830
NE
1041C0700X
Clinical Social Worker
7688
NE
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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