Provider Demographics
NPI:1629421698
Name:ROBACK, STEFANIE LYNN (MSW, LCSW, LCAS)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:LYNN
Last Name:ROBACK
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 CAUSEWAY DR STE A2
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28480-1959
Mailing Address - Country:US
Mailing Address - Phone:910-408-2302
Mailing Address - Fax:
Practice Address - Street 1:530 CAUSEWAY DR STE A2
Practice Address - Street 2:
Practice Address - City:WRIGHTSVILLE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28480-1959
Practice Address - Country:US
Practice Address - Phone:910-408-2302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical