Provider Demographics
NPI:1659181667
Name:REYNOLDS, STACY (LMFT-A)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 BUTTERNUT ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-2523
Mailing Address - Country:US
Mailing Address - Phone:325-261-3663
Mailing Address - Fax:
Practice Address - Street 1:1017 BUTTERNUT ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-2523
Practice Address - Country:US
Practice Address - Phone:325-261-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205804106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist