Provider Demographics
NPI:1144394271
Name:JATEGAONKAR, STEPHANIE WHITNEY (MA, LPC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:WHITNEY
Last Name:JATEGAONKAR
Suffix:
Gender:F
Credentials:MA, LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 HOLLYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3521
Mailing Address - Country:US
Mailing Address - Phone:314-504-3762
Mailing Address - Fax:
Practice Address - Street 1:425 N NEW BALLAS RD STE 285
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6877
Practice Address - Country:US
Practice Address - Phone:314-266-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004032922221700000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist