Provider Demographics
NPI:1487030771
Name:STEHLE, JUSTINE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUSTINE
Middle Name:
Last Name:STEHLE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7207 CHARLTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2450
Mailing Address - Country:US
Mailing Address - Phone:917-544-1601
Mailing Address - Fax:
Practice Address - Street 1:7207 CHARLTON ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2450
Practice Address - Country:US
Practice Address - Phone:917-544-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0180831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical