Provider Demographics
NPI:1508471798
Name:WASSERMAN, STEPHANIE MCLAIN (LPC, MHSP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MCLAIN
Last Name:WASSERMAN
Suffix:
Gender:F
Credentials:LPC, MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10411 KATES PATH LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-1574
Mailing Address - Country:US
Mailing Address - Phone:865-705-4020
Mailing Address - Fax:
Practice Address - Street 1:10411 KATES PATH LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-1574
Practice Address - Country:US
Practice Address - Phone:865-705-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000003249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional