Provider Demographics
NPI:1538145537
Name:KLOPFER, STEPHANIE J (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:J
Last Name:KLOPFER
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MAC BLVD
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3990
Mailing Address - Country:US
Mailing Address - Phone:417-667-2262
Mailing Address - Fax:417-667-6515
Practice Address - Street 1:1800 COMMUNITY
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MO
Practice Address - Zip Code:64735-8804
Practice Address - Country:US
Practice Address - Phone:660-890-8183
Practice Address - Fax:816-318-3109
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000169031101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
454695OtherHEALTHLINK
6082C10OtherBLUE CROSS
MO499087609Medicaid