Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | LCPC-7165 | ID |
Y | 101YP2500X | Professional Counselor | LCPC-7165 | ID |
N | 101YP2500X | Professional Counselor | SUPERVISOR | ID |
NPI | 1003368358 |
---|---|
Provider Name | Stephanie Ann Sternes |
First Address | Emmett, ID 83617-8855 |
Second Address | Emmett, ID 83617-2776 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2016 |
Last Update Date | 04/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1316373301 | THE COMPANY I WORK FORS NPI IS 1316373301 (01) | ID |
1568933521 | A COMPANY THAT I WORK FORR (01) | ID |
463685355 | THE TAX ID FOR THE COMPANY I WORK FOR IS 463685355 (01) |