Individual ProviderStacey CablkMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address160 Wikiup Dr Ste 102, Santa Rosa, CA 95403-7776(510) 213-0259PECOS EnrollmentBased on the most recent information from CMS, provider Stacey Cablk does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1427532720Provider TypeIndividualFull NameCablk, StaceyCredentialMA, LMFTGenderFemaleSole ProprietorNoEnumeration Date9/21/2018Last Updated9/21/2018Contact InformationPractice LocationPractice Address160 Wikiup Dr Ste 102, Santa Rosa, CA 95403-7776Phone(510) 213-0259FaxUnlisted FaxMailing LocationMailing Address160 Wikiup Dr Ste 102, Santa Rosa, CA 95403-7776Phone(510) 213-0259FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseMFC53453California