Provider Demographics
NPI:1114152162
Name:STENDER, JOELLEN (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:JOELLEN
Middle Name:
Last Name:STENDER
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:JOELLEN
Other - Middle Name:
Other - Last Name:DINSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:2107 SPRUCE STREET
Mailing Address - City:NORTH COLLINS
Mailing Address - State:NY
Mailing Address - Zip Code:14111-0458
Mailing Address - Country:US
Mailing Address - Phone:716-337-3706
Mailing Address - Fax:
Practice Address - Street 1:2107 SPRUCE STREET
Practice Address - Street 2:
Practice Address - City:NORTH COLLINS
Practice Address - State:NY
Practice Address - Zip Code:14111-0458
Practice Address - Country:US
Practice Address - Phone:716-337-3706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004866101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health