| Doctor Name: | MRS. STACEY LEE ANGUS |
| NPI Number: | 1629234786 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW,CAS, MAC |
| License Number: | C-4560 |
| Business Practice Address: | 129 Hudson St South Glens Falls, NY - 128034923 |
| Business Phone Number: | 5184799971 |
| Business Fax Number: | |
| Mailing Address: | 129 Hudson St, SOUTH GLENS FALLS |
| State: | NY |
| Postal Code: | 128034923 |
| Phone Number: | 5184799971 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2008 |
| NPI Last Update Date: | 11/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | C-4560 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |