Provider Demographics
NPI:1124547211
Name:HENSCHEN, STEPHANIE L (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:HENSCHEN
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 1:767 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-5101
Mailing Address - Country:US
Mailing Address - Phone:330-418-3634
Mailing Address - Fax:330-884-6120
Practice Address - Street 1:1390 S ARCH AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4111
Practice Address - Country:US
Practice Address - Phone:330-821-3961
Practice Address - Fax:330-884-6120
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1100336101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional