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Individual

MS. STACIE M PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1209 N FANT ST, ANDERSON, SC 29621-4821
(864) 353-3384
Mailing address
858 CROUCH DR, PENDLETON, SC 29670-1516
(678) 488-5693

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11822
SC
101YP2500X
Professional Counselor
Primary
8849
SC

Other

Enumeration date
07/06/2024
Last updated
01/30/2026
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