Individual
STACEY LYN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
1675 CURLEW DR, AMMON, ID 83406-4718
(208) 523-5319
Mailing address
PO BOX 2106, IDAHO FALLS, ID 83403-2106
(208) 360-2850
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LMSW-30182
ID
101YM0800X
Mental Health Counselor
LMSW-30182
ID
104100000X
Social Worker
LMSW-30182
ID
1041C0700X
Clinical Social Worker
Primary
35279
ID
1041C0700X
Clinical Social Worker
LMSW-30182
ID
Other
Enumeration date
01/06/2010
Last updated
06/25/2025
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