Provider Demographics
NPI:1578802567
Name:URBINO, STEPHANIE MARYANN (LMSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARYANN
Last Name:URBINO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 E HAZELTINE AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2705
Mailing Address - Country:US
Mailing Address - Phone:716-361-5524
Mailing Address - Fax:
Practice Address - Street 1:37 E HAZELTINE AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-2705
Practice Address - Country:US
Practice Address - Phone:716-361-5524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075837-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker