Individual
STACY L. MCKENZIE-BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
404 EUCLID AVE, PAINTSVILLE, KY 41240-1167
(606) 889-1602
(606) 263-4467
Mailing address
PO BOX 390, HUNTINGTON, WV 25708-0390
(304) 429-1088
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
171280
KY
Other
Enumeration date
11/01/2006
Last updated
05/14/2024
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