1306398946 NPI number — MS. STEPHANIE LYNN STENDER LBSW

Table of content: MS. STEPHANIE LYNN STENDER LBSW (NPI 1306398946)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306398946 NPI number — MS. STEPHANIE LYNN STENDER LBSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STENDER
Provider First Name:
STEPHANIE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LBSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306398946
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 HANCOCK STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48602-4224
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-797-3400
Provider Business Mailing Address Fax Number:
989-799-0206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 HANCOCK STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48602-4224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-797-3400
Provider Business Practice Location Address Fax Number:
989-799-0206
Provider Enumeration Date:
10/31/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 175T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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