Provider Demographics
NPI:1578969002
Name:PELLAND, STEPHANIE (LMHC, LPCMHSP, LCMHC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:PELLAND
Suffix:
Gender:F
Credentials:LMHC, LPCMHSP, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 DAYTON BLVD UNIT 15781
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-4764
Mailing Address - Country:US
Mailing Address - Phone:423-827-5300
Mailing Address - Fax:
Practice Address - Street 1:5129 MCCAHILL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-1709
Practice Address - Country:US
Practice Address - Phone:423-827-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6591101YM0800X
VT068.0135701101YM0800X
MA8885101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health