Provider Demographics
NPI:1366231409
Name:SOBEY, STACIA (LPC)
Entity type:Individual
Prefix:
First Name:STACIA
Middle Name:
Last Name:SOBEY
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 STILLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:SC
Mailing Address - Zip Code:29827-6647
Mailing Address - Country:US
Mailing Address - Phone:816-377-8757
Mailing Address - Fax:
Practice Address - Street 1:49 PENNINGTON DR STE C
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-9014
Practice Address - Country:US
Practice Address - Phone:803-702-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019047995101YP2500X
SC10281101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional