Provider Demographics
NPI:1306016886
Name:DERHOVHANNESSIAN, STEPHANIE SCHUCHERT (LCSW)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:SCHUCHERT
Last Name:DERHOVHANNESSIAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 SANTA ROSA RD RM 211
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5105
Mailing Address - Country:US
Mailing Address - Phone:804-303-9622
Mailing Address - Fax:
Practice Address - Street 1:1503 SANTA ROSA RD RM 211
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-5105
Practice Address - Country:US
Practice Address - Phone:804-303-9622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040067261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical