Individual
MR. STACEY GLENN STOCKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHC, ASUDC, TRS
Contact information
Practice address
375 RAINBOW LN, MIDWAY, UT 84049-7001
(435) 654-1082
(435) 654-1482
Mailing address
1060 S DAVIS BLVD, BOUNTIFUL, UT 84010-2016
(801) 231-9592
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
108034-6008
UT
101YM0800X
Mental Health Counselor
Primary
108034-6004
UT
225800000X
Recreation Therapist
108034-4002
UT
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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