Individual
STACIE R CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A, LPC, LMFT
Contact information
Practice address
1525 STEPHENS AVE, SHREVEPORT, LA 71101-4705
(318) 221-6121
(318) 222-7879
Mailing address
9610 BALSA DR, SHREVEPORT, LA 71115-3179
(318) 798-2198
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YM0800
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2630
LPC
LA
01
—
912
LMFT
LA
Enumeration date
11/01/2006
Last updated
07/08/2007
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