Provider Demographics
NPI:1629448220
Name:STEPHANIE PEARCE THERAPY LLC
Entity Type:Organization
Organization Name:STEPHANIE PEARCE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-300-1163
Mailing Address - Street 1:725 OVERVIEW TER
Mailing Address - Street 2:
Mailing Address - City:EFFORT
Mailing Address - State:PA
Mailing Address - Zip Code:18330-8021
Mailing Address - Country:US
Mailing Address - Phone:908-300-1163
Mailing Address - Fax:855-507-9439
Practice Address - Street 1:2334 ROUTE 209
Practice Address - Street 2:
Practice Address - City:SCIOTA
Practice Address - State:PA
Practice Address - Zip Code:18354-7734
Practice Address - Country:US
Practice Address - Phone:908-300-1163
Practice Address - Fax:855-507-9439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0182071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102994026 0001Medicaid