Provider Demographics
NPI:1881216489
Name:MOSHER, STACY KARP (LCPC-C)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:KARP
Last Name:MOSHER
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:
Other - Last Name:KARP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:10 TIMBER CREEK DR UNIT 1
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2711
Mailing Address - Country:US
Mailing Address - Phone:207-314-3304
Mailing Address - Fax:
Practice Address - Street 1:25 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4869
Practice Address - Country:US
Practice Address - Phone:207-613-6367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-18
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC7064101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health