Provider Demographics
NPI:1568828176
Name:DR. GAGE STERMENSKY LLC
Entity Type:Organization
Organization Name:DR. GAGE STERMENSKY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GAGE
Authorized Official - Middle Name:
Authorized Official - Last Name:STERMENSKY
Authorized Official - Suffix:II
Authorized Official - Credentials:PSYD
Authorized Official - Phone:417-413-0085
Mailing Address - Street 1:1723 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-2446
Mailing Address - Country:US
Mailing Address - Phone:417-413-0085
Mailing Address - Fax:308-832-4844
Practice Address - Street 1:1723 AVENUE A
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-2446
Practice Address - Country:US
Practice Address - Phone:417-413-0085
Practice Address - Fax:308-832-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE885103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty