Provider Demographics
NPI:1174335962
Name:LENGACHER, STACEY (LMT)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:LENGACHER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9770
Mailing Address - Country:US
Mailing Address - Phone:260-341-7564
Mailing Address - Fax:
Practice Address - Street 1:37 BANK ST STE 5
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-5880
Practice Address - Country:US
Practice Address - Phone:260-341-7564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INMT22207876225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist