Individual
STACY E MASTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., L.C.S.W.
Contact information
Practice address
804 AINSWORTH DR, STE 105, PRESCOTT, AZ 86301-1624
(928) 777-0919
(928) 777-8897
Mailing address
PO BOX 486, HUMBOLDT, AZ 86329-0486
(928) 777-0919
(928) 777-8897
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW3469
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
748337
—
AZ
Enumeration date
05/31/2005
Last updated
09/28/2007
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