Individual provider · Type 1 NPI

Stacy Melissa Ishack

Professional Counselor · Bridgeport, CT

NPI number 1124786546 Active

Practice location

475 Clinton Ave
Bridgeport, CT 06605-1700

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X5029 (CT)
Professional Counselor Primary 101YP2500X5029 (CT)

Professional Counselor: Definition to come...

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About NPI 1124786546

Stacy Melissa Ishack's National Provider Identifier is 1124786546, issued on Dec 2, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bridgeport, CT. The record was last updated on Dec 2, 2021.