Provider Demographics
NPI:1417903238
Name:HITTLE, STEPHANIE I (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:I
Last Name:HITTLE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 E SPRING VALLEY RD
Mailing Address - Street 2:STE B
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3803
Mailing Address - Country:US
Mailing Address - Phone:937-291-1351
Mailing Address - Fax:937-291-1719
Practice Address - Street 1:180 E SPRING VALLEY RD
Practice Address - Street 2:STE B
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-3803
Practice Address - Country:US
Practice Address - Phone:937-291-1351
Practice Address - Fax:937-291-1719
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002521101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional