Individual
MRS. STACI JO CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
13399 STATE HIGHWAY 2, GRAYSON, KY 41143-8640
(606) 713-3853
Mailing address
13399 STATE HIGHWAY 2, GRAYSON, KY 41143-8640
(606) 713-3853
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
7394
KY
104100000X
Social Worker
S.1903345
OH
1041C0700X
Clinical Social Worker
Primary
I.2607648
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0334428
—
OH
05
—
7100620870
—
KY
01
—
S.1903345
LICENSED SOCIAL WORKER
OH
Enumeration date
08/27/2015
Last updated
02/02/2026
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