Provider Demographics
NPI:1124213483
Name:WASIL, STEFANI JEAN (LPC NCC)
Entity Type:Individual
Prefix:MRS
First Name:STEFANI
Middle Name:JEAN
Last Name:WASIL
Suffix:
Gender:F
Credentials:LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 S SHENANDOAH DR
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-2419
Mailing Address - Country:US
Mailing Address - Phone:724-433-3054
Mailing Address - Fax:
Practice Address - Street 1:706 S SHENANDOAH DR
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-2419
Practice Address - Country:US
Practice Address - Phone:724-433-3054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004695101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional