1447857727 NPI number — STEPHANIE LYNN HARRIS LCSW, CADC

Table of content: RONALD V BEYER MD (NPI 1154381523)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447857727 NPI number — STEPHANIE LYNN HARRIS LCSW, CADC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRIS
Provider First Name:
STEPHANIE
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW, CADC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CLYMER
Provider Other First Name:
STEPHANIE
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW, CADC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447857727
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14208 E WESTLAND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85262-6201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-242-1451
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8955 E PINNACLE PEAK RD STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85255-3624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-944-9400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/08/2020

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: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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