Provider Demographics
NPI:1477006286
Name:MAHAFFEY, STEPHANY LYNNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANY
Middle Name:LYNNE
Last Name:MAHAFFEY
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 1:3001 ALOMA AVE STE 229
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3752
Mailing Address - Country:US
Mailing Address - Phone:407-965-3563
Mailing Address - Fax:407-569-0527
Practice Address - Street 1:3001 ALOMA AVE STE 229
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3752
Practice Address - Country:US
Practice Address - Phone:407-965-3563
Practice Address - Fax:407-569-0527
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9160103TC1900X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling