Provider Demographics
NPI:1598109209
Name:JORENBY, STEFANIE (LMHC, MCAP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:JORENBY
Suffix:
Gender:F
Credentials:LMHC, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 FEMRITE DR
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53716-3716
Mailing Address - Country:US
Mailing Address - Phone:608-222-7311
Mailing Address - Fax:608-204-3832
Practice Address - Street 1:325 SW 28TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-2612
Practice Address - Country:US
Practice Address - Phone:954-354-4849
Practice Address - Fax:951-357-4816
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5743-125101YP2500X
WI16043-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional