Provider Demographics
NPI:1417559576
Name:STACHOFSKY, SOPHIA LORAINE (LMSW)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:LORAINE
Last Name:STACHOFSKY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12909 W 116TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1328
Mailing Address - Country:US
Mailing Address - Phone:303-356-7489
Mailing Address - Fax:
Practice Address - Street 1:12909 W 116TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-1328
Practice Address - Country:US
Practice Address - Phone:303-356-7489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS91211041C0700X
MO20190182741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical