Provider Demographics
NPI:1003368358
Name:STERNES, STEPHANIE ANN (LCPC, LAMFT, NCC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:STERNES
Suffix:
Gender:F
Credentials:LCPC, LAMFT, NCC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:HUNDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8611 DEWEY RD
Mailing Address - Street 2:
Mailing Address - City:EMMETT
Mailing Address - State:ID
Mailing Address - Zip Code:83617-8855
Mailing Address - Country:US
Mailing Address - Phone:208-369-3724
Mailing Address - Fax:844-696-1471
Practice Address - Street 1:1016 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:EMMETT
Practice Address - State:ID
Practice Address - Zip Code:83617-2776
Practice Address - Country:US
Practice Address - Phone:208-918-0054
Practice Address - Fax:844-696-1471
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-7165101YM0800X, 172V00000X, 101YP2500X
IDSUPERVISOR101YP2500X
IDLAMFT-6458106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1316373301OtherTHE COMPANY I WORK FORS NPI IS 1316373301
463685355OtherTHE TAX ID FOR THE COMPANY I WORK FOR IS 463685355
ID1568933521OtherA COMPANY THAT I WORK FORR