Stacy Lynn Tackett
Counselor, Addiction (Substance Use Disorder) in Waverly, OH. Individual provider (NPI-1).
NPI number1063146751
StatusActive
Last updated in NPPESJul 11, 2022
Details
- NPI
- 1063146751
- Entity type
- Individual (NPI-1)
- Name
- Stacy Lynn Tackett
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 11, 2022
- Certification date
- Jul 11, 2022
- Last updated
- Jul 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
196 E Emmitt AveWaverly, OH 45690-1334
Phone 740-912-9499
Mailing address
1174 Millers LnWaverly, OH 45690-9719
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All 356 Addiction (Substance Use Disorder) Counselor providers in Waverly · All 759 providers in Waverly
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