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Individual

MRS. STACY ANNETTE IVERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.S.W.

Contact information

Practice address
1200 BLAZEWOOD ST, RIVERSIDE, CA 92507-5909
(951) 377-1087
(951) 683-3323
Mailing address
1200 BLAZEWOOD ST, RIVERSIDE, CA 92507-5909
(951) 377-1087
(951) 683-3323

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
R51A (#070191978)
CA
1041C0700X
Clinical Social Worker
LCS 17495
CA

Other

Enumeration date
05/24/2007
Last updated
09/11/2025
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