Provider Demographics
NPI:1326711490
Name:ZEPEDA, STEPHANIE (PLADC, PLMHP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ZEPEDA
Suffix:
Gender:F
Credentials:PLADC, PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5044
Mailing Address - Country:US
Mailing Address - Phone:402-371-0220
Mailing Address - Fax:
Practice Address - Street 1:910 W PARK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5044
Practice Address - Country:US
Practice Address - Phone:402-371-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1892101YA0400X
NE12683101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)