Provider Demographics
NPI:1083368989
Name:STEPANOV, NATALIA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:
Last Name:STEPANOV
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 GALT OCEAN DR APT 1814
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-6837
Mailing Address - Country:US
Mailing Address - Phone:954-300-5136
Mailing Address - Fax:
Practice Address - Street 1:3500 GALT OCEAN DR APT 1814
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-6837
Practice Address - Country:US
Practice Address - Phone:954-300-5136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health