Provider Demographics
NPI:1316033897
Name:FALK, STEPHANIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:FALK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 EAST LEHMAN STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-4013
Mailing Address - Country:US
Mailing Address - Phone:717-270-6550
Mailing Address - Fax:717-270-6550
Practice Address - Street 1:502 EAST LEHMAN STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046-4013
Practice Address - Country:US
Practice Address - Phone:717-270-6550
Practice Address - Fax:717-270-6550
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008325L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAFA898966Medicare ID - Type Unspecified