Provider Demographics
NPI:1619017506
Name:ADAMKIN DELAMBRE, STEPHANIE M (MS, LPP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:ADAMKIN DELAMBRE
Suffix:
Gender:F
Credentials:MS, LPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13207 HOLLY FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-2107
Mailing Address - Country:US
Mailing Address - Phone:502-553-4045
Mailing Address - Fax:
Practice Address - Street 1:13207 HOLLY FOREST RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245
Practice Address - Country:US
Practice Address - Phone:502-553-4045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2006-35103T00000X
KY135918103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid
KY30615058Medicaid