Jacob Garrett Stacy, LCSW, CSAT

NPI #1750954343 in Logan, Utah

Provider Information

NPI Number: 1750954343
Entity Type: Individual
Name: Jacob Garrett Stacy, LCSW, CSAT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LCSW, CSAT
Enumeration Date: Jul 21, 2021
Last Updated: Jul 21, 2021

Practice Location

Address: 40 W CACHE VALLEY BLVD STE 10A
City: Logan
State: Utah
ZIP Code: 84341-8450
Phone: (435) 787-2272

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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