Provider Demographics
NPI:1215188941
Name:MINCH, STEPHANIE ANNE (LGSW)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ANNE
Last Name:MINCH
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 STAMFORD DR
Mailing Address - Street 2:# 211
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-2785
Mailing Address - Country:US
Mailing Address - Phone:302-454-1833
Mailing Address - Fax:
Practice Address - Street 1:500 STAMFORD DR
Practice Address - Street 2:# 211
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-2785
Practice Address - Country:US
Practice Address - Phone:302-454-1833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14323104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker