Individual
DR. STACEY LEE WARING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176-4544
(703) 771-5100
(703) 777-0170
Mailing address
3373 HICKORY HILLS DR, OAKTON, VA 22124-2306
(703) 758-2550
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293823
AMERIGROUP
VA
01
—
384563
ANTHEM
VA
Enumeration date
08/30/2006
Last updated
07/08/2007
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