Provider Demographics
NPI:1386652717
Name:DARNELL, STEPHANIE BROOKE (LMHC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:BROOKE
Last Name:DARNELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 EISENHOWER BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-6344
Mailing Address - Country:US
Mailing Address - Phone:813-290-8560
Mailing Address - Fax:813-354-2416
Practice Address - Street 1:4902 EISENHOWER BLVD STE 315
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6344
Practice Address - Country:US
Practice Address - Phone:813-290-8560
Practice Address - Fax:813-354-2416
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health