Provider Demographics
NPI:1497720742
Name:WHITSEL-ANDERSON, STEPHANIE A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:A
Last Name:WHITSEL-ANDERSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:A
Other - Last Name:WHITSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2520 NEW BUTLER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-3225
Mailing Address - Country:US
Mailing Address - Phone:724-856-3657
Mailing Address - Fax:724-856-3658
Practice Address - Street 1:2520 NEW BUTLER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-3225
Practice Address - Country:US
Practice Address - Phone:724-856-3657
Practice Address - Fax:724-856-3658
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015410103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10096115-0003Medicaid