Provider Demographics
NPI:1477875367
Name:MILBURN, STEPHEN JOSEPH (LPC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:MILBURN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 BALA PLAZA
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1512
Mailing Address - Country:US
Mailing Address - Phone:267-945-1617
Mailing Address - Fax:267-945-1617
Practice Address - Street 1:2 BALA PLAZA
Practice Address - Street 2:SUITE 300
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1512
Practice Address - Country:US
Practice Address - Phone:267-945-1617
Practice Address - Fax:267-945-1617
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003069101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)