| Stacie Thaxton, LPCC, NCC | |
|
945 River Rd, Granville, OH 43023-9534 | |
| (740) 587-5252 | |
| (740) 587-2571 |
| Full Name | Stacie Thaxton |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 945 River Rd, Granville, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245693357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | E.1400025 (Ohio) | Primary |
| 101YM0800X | Counselor - Mental Health | E.1400025 (Ohio) | Secondary |
| Entity Name | Newark-granville Psychological & Counseling Services Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891808648 PECOS PAC ID: 6800879107 Enrollment ID: O20040609000081 |
| Mailing Address | Practice Location Address |
|---|---|
| Stacie Thaxton, LPCC, NCC Po Box 481, Granville, OH 43023-0481 Ph: (740) 587-5252 | Stacie Thaxton, LPCC, NCC 945 River Rd, Granville, OH 43023-9534 Ph: (740) 587-5252 |
Sherry E Cotterman-fischer, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 935 River Rd, Suite I, Granville, OH 43023 Phone: 740-755-8051 Fax: 740-366-8940 | |
Karen A Tinsley, MA, LPC, CTMH Counselor Medicare: Not Enrolled in Medicare Practice Location: 905 River Rd Ste B, Granville, OH 43023 Phone: 740-507-6707 Fax: 740-920-4244 | |
Laura Kay Freidner, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1965 Newark Granville Rd, Granville, OH 43023 Phone: 740-334-1373 | |
Jeannette B. Clark, MSED., LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 941 River Rd, Granville, OH 43023 Phone: 740-587-1543 Fax: 740-587-1573 | |
Stephen Walters, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 N Prospect St, Granville, OH 43023 Phone: 740-277-8050 | |
Arline Iannicello, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1943 Newark Granville Rd, Granville, OH 43023 Phone: 740-587-5252 Fax: 740-587-2571 |