Provider Demographics
NPI:1124370606
Name:HERSHONIK, STANLEY III (MS)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:
Last Name:HERSHONIK
Suffix:III
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19044 SE ARNOLD DR
Mailing Address - Street 2:
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-1681
Mailing Address - Country:US
Mailing Address - Phone:203-430-0077
Mailing Address - Fax:
Practice Address - Street 1:1645 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5428
Practice Address - Country:US
Practice Address - Phone:877-591-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst