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Mr. John Leroy Stacy JR., CSAC,LPC
Professional Counselor in Norfolk, Virginia
NPI 1306182795

John Leroy Stacy JR. is a Professional Counselor based in Norfolk, VA and is specialized in Professional. John Leroy Stacy JR. practices in Norfolk, VA and has the professional credentials of CSAC,LPC. The NPI Number for John Leroy Stacy JR. is 1306182795 and holds a License No. 0710102681 (Virginia).

The current practice location address for John Leroy Stacy JR. is 1216 Granby St Ste 211, Norfolk, VA and can be reached out via phone at 757-632-0343.

Location: 1216 Granby St Ste 211, Norfolk, VA, 23510-2622
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306182795
Provider Name
John Leroy Stacy JR.
Credential
CSAC,LPC
Provider Entity Type
Individual
Gender
Male
Address
1216 Granby St Ste 211, Norfolk, VA, 23510-2622
Phone Number
757-632-0343
Fax Number
Provider Enumeration Date
12/12/2012
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1245936616 05 VA
institution
Provider Business Practice Location Address Details
Address
1216 Granby St Ste 211
City
Norfolk
State
Virginia
Zip
23510-2622
Phone Number
757-632-0343
Fax Number
person
Provider Business Mailing Address Details
Address
1216 Granby St Ste 211
City
Norfolk
State
Virginia
Zip
23510-2622
Phone Number
757-632-0343
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
0701006465 (Virginia)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
0710102681 (Virginia)
Definition
Definition to come...
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