Individual provider · Type 1 NPI

Stacia Jacobson-Gray, LPCC

Professional Counselor · Minnetonka, MN

NPI number 1457658981 Active

Practice location

3395 Plymouth Rd
Minnetonka, MN 55305-3765

Call (952) 939-0396 Map

Fax (952) 548-8760

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Professional Counselor Primary 101YP2500XCC01218 (MN)

Professional Counselor: Definition to come...

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About NPI 1457658981

Stacia Jacobson-Gray, LPCC's National Provider Identifier is 1457658981, issued on Feb 18, 2011. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Minnetonka, MN. The record was last updated on May 16, 2016.