Provider Demographics
NPI:1538329925
Name:DRUCKMAN, STEPHANIE MICHELE (MA)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MICHELE
Last Name:DRUCKMAN
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 1:4152 MERIDIAN ST
Mailing Address - Street 2:ST 105/PMB #103
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-0000
Mailing Address - Country:US
Mailing Address - Phone:360-483-8824
Mailing Address - Fax:
Practice Address - Street 1:4824 GREEN VISTA WAY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8827
Practice Address - Country:US
Practice Address - Phone:360-483-8824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00034833101YA0400X, 101YM0800X
WALH60563469101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)