Provider Demographics
NPI:1083131874
Name:MARNOCHA, STEPHANIE F (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:F
Last Name:MARNOCHA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 E EASTER LN
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1136
Mailing Address - Country:US
Mailing Address - Phone:303-213-1320
Mailing Address - Fax:
Practice Address - Street 1:9700 E EASTER LN
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1136
Practice Address - Country:US
Practice Address - Phone:303-213-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0009921275104100000X
CO099261931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker