Individual
STACY RAE WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CRC
Contact information
Practice address
801 W RICHARDS ST, DOUGLAS, WY 82633-8931
(307) 358-9771
Mailing address
801 W RICHARDS ST, DOUGLAS, WY 82633-8931
(307) 358-9771
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-1878
WY
101YS0200X
School Counselor
Primary
61341
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61341
PROFESSIONAL TEACHING STANDARDS BOARD SCHOOL COUNSELING LICENSE
WY
01
—
LPC-1878
MENTAL HEALTH PROFESSIONS LICENSING BOARD
WY
Enumeration date
05/11/2022
Last updated
09/28/2022
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