Provider Demographics
NPI:1518393982
Name:DENNIS, STEPHANIE M (MA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 78TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-2624
Mailing Address - Country:US
Mailing Address - Phone:718-450-5248
Mailing Address - Fax:
Practice Address - Street 1:1160 78TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2624
Practice Address - Country:US
Practice Address - Phone:718-450-5248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical