Provider Demographics
NPI:1649759192
Name:LYON-STIRLING, STEPHANIE JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:JEAN
Last Name:LYON-STIRLING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:LYON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27 COLLINWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1035
Mailing Address - Country:US
Mailing Address - Phone:201-874-5109
Mailing Address - Fax:
Practice Address - Street 1:3-5 VOSE AVE STE 6
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2006
Practice Address - Country:US
Practice Address - Phone:973-498-8344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022455103TC0700X
NJ35SI00584100103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical