Provider Demographics
NPI:1568496487
Name:STOCKI, STEPHANIE (PSYD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:STOCKI
Suffix:
Gender:F
Credentials:PSYD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-5426
Mailing Address - Country:US
Mailing Address - Phone:570-322-5051
Mailing Address - Fax:570-322-6788
Practice Address - Street 1:1521 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5426
Practice Address - Country:US
Practice Address - Phone:570-322-5051
Practice Address - Fax:570-322-6788
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW012768101YM0800X, 1041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11883OtherCIGNA BEHAVIORAL HEALTH
PA808212OtherFIRST PRIORITY HEALTH
PA042818OtherVALUE OPTIONS
049292PXOMedicare PIN
PAP35321Medicare UPIN