Individual
STACEY LEA INGRAM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC, LSATP
Contact information
Practice address
215 W ATLANTIC ST, EMPORIA, VA 23847-1223
(434) 634-5181
Mailing address
805 HAWTHORNE DR, BRACEY, VA 23919-1956
(434) 636-5318
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0718000154
VA
101YP2500X
Professional Counselor
0701003316
VA
Other
Enumeration date
06/12/2006
Last updated
09/11/2025
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