Individual
STACY R CHAMBERLAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMAC
Contact information
Practice address
6331 W 110TH ST, OVERLAND PARK, KS 66211-1509
(913) 696-1911
(913) 696-1619
Mailing address
6331 W 110TH ST, OVERLAND PARK, KS 66211-1509
(913) 696-1911
(913) 696-1619
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
204
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
204
BEHAVIORAL SCIENCES REGULATORY BOARD
KS
Enumeration date
08/21/2018
Last updated
08/21/2018
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