Provider Demographics
NPI:1659790046
Name:FAGLIANO, STEPHANIE MICHELE (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELE
Last Name:FAGLIANO
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 1:5142 HOLLISTER AVE UNIT A101
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2526
Mailing Address - Country:US
Mailing Address - Phone:805-203-3048
Mailing Address - Fax:805-364-5950
Practice Address - Street 1:5142 HOLLISTER AVE UNIT A101
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2526
Practice Address - Country:US
Practice Address - Phone:805-203-3048
Practice Address - Fax:805-364-5950
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA819561041C0700X, 1041C0700X
CA66598104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker