Provider Demographics
NPI:1275049892
Name:STEPHANIE M. HADLEY
Entity Type:Organization
Organization Name:STEPHANIE M. HADLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCABA
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SATTIE
Authorized Official - Suffix:
Authorized Official - Credentials:BSED
Authorized Official - Phone:757-667-0660
Mailing Address - Street 1:933 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-8723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:760 LYNNHAVEN PKWY
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7325
Practice Address - Country:US
Practice Address - Phone:757-667-0660
Practice Address - Fax:877-727-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty