Individual
STACIE WELDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REVEREND
Contact information
Practice address
560 KELLER AVENUE, ELMONT, NY 11003
(516) 424-1520
Mailing address
560 KELLER AVENUE, ELMONT, NY 11003
(516) 424-1520
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
171100000X
Acupuncturist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
—
175F00000X
Naturopath
—
—
175L00000X
Homeopath
—
—
Other
Enumeration date
10/06/2009
Last updated
12/26/2012
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