Provider Demographics
NPI:1669282364
Name:LANIER, STACY (LMFT-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:LANIER
Suffix:
Gender:
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 E WHITESTONE BLVD UNIT 81
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-1909
Mailing Address - Country:US
Mailing Address - Phone:706-905-6054
Mailing Address - Fax:
Practice Address - Street 1:1210 COTTONWOOD CREEK TRL STE 300
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2688
Practice Address - Country:US
Practice Address - Phone:512-677-9433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205746106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist