Provider Demographics
NPI:1598143612
Name:STEPHANIE VINES, NCC, LPC, LLC
Entity Type:Organization
Organization Name:STEPHANIE VINES, NCC, LPC, LLC
Other - Org Name:A LISTENING PRESENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VINES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:337-380-6803
Mailing Address - Street 1:P.O. BOX 11427
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70562
Mailing Address - Country:US
Mailing Address - Phone:337-380-6803
Mailing Address - Fax:
Practice Address - Street 1:152 W. MAIN ST.
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560
Practice Address - Country:US
Practice Address - Phone:337-380-6803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2390251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health