Provider Demographics
NPI:1689970709
Name:BAUGHMAN, STACEY (LPC)
Entity type:Individual
Prefix:MS
First Name:STACEY
Middle Name:
Last Name:BAUGHMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18789 N REEMS RD STE 260H
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8648
Mailing Address - Country:US
Mailing Address - Phone:623-910-3371
Mailing Address - Fax:877-244-9683
Practice Address - Street 1:18789 N REEMS RD STE 260H
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-8648
Practice Address - Country:US
Practice Address - Phone:623-910-3371
Practice Address - Fax:877-244-9683
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13316101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional