Provider Demographics
NPI:1639104185
Name:WARNOCK, STEPHANIE J (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:WARNOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4048 LAUREL ST
Mailing Address - Street 2:STE 305
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5391
Mailing Address - Country:US
Mailing Address - Phone:907-561-0044
Mailing Address - Fax:907-561-5478
Practice Address - Street 1:4048 LAUREL ST
Practice Address - Street 2:STE 305
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5391
Practice Address - Country:US
Practice Address - Phone:907-561-0044
Practice Address - Fax:907-561-5478
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
152017Medicare ID - Type Unspecified