Individual
MS. STACY HAAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC/MHSP
Contact information
Practice address
105 OTIS SMITH DR, CLARKSVILLE, TN 37043-8940
(931) 320-9213
Mailing address
105 OTIS SMITH DR, CLARKSVILLE, TN 37043-8940
(931) 320-9213
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
1407
MS
101YP2500X
Professional Counselor
Primary
3299
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407
MISSISSIPPI STATE BOARD OF EXAMINERS FOR LICENSED PROFESSIONAL COUNSELORS
MS
01
—
290113
KENTUCKY STATE BOARD OF PROF. COUNSELORS
KY
01
—
3299
TN BOARD OF PROF. COUNSELORS AND MARTIAL AND FAMILY THERAPISTS LICENSED PASTORAL
TN
01
—
PH1444
MS DEPT OF MENTAL HEALTH
MS
Enumeration date
12/19/2007
Last updated
05/06/2024
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