Individual
STACEY RENE GARCELON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. LMHCA, NCC
Contact information
Practice address
4298 E 1000 N, LA PORTE, IN 46350-8327
(219) 448-8109
Mailing address
4298 E 1000 N, LA PORTE, IN 46350-8327
(219) 448-8109
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88001186A
IN
Other
Enumeration date
03/27/2021
Last updated
03/27/2021
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