Provider Demographics
NPI:1609906320
Name:CATER, STEPHANIE LEE (LCPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEE
Last Name:CATER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SUMMIT PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2821
Mailing Address - Country:US
Mailing Address - Phone:207-939-0114
Mailing Address - Fax:
Practice Address - Street 1:49 ATLANTIC PL
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2316
Practice Address - Country:US
Practice Address - Phone:207-756-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1910101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional