Provider Demographics
NPI:1083993125
Name:SPEIDEL, STEPHANIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:SPEIDEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16010 GREYMILL MANOR DR
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-4960
Mailing Address - Country:US
Mailing Address - Phone:540-300-6150
Mailing Address - Fax:
Practice Address - Street 1:32 WATERLOO ST STE 108
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3219
Practice Address - Country:US
Practice Address - Phone:540-300-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor