Provider Demographics
NPI:1689780983
Name:STERLING, STEPHANIE LYNN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:STERLING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11700 PLYMOUTH WOODS DR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-4507
Mailing Address - Country:US
Mailing Address - Phone:734-464-3499
Mailing Address - Fax:734-464-3499
Practice Address - Street 1:11700 PLYMOUTH WOODS DR
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-4507
Practice Address - Country:US
Practice Address - Phone:734-464-3499
Practice Address - Fax:734-464-3499
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010598891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801059889Medicare PIN
MIN90370008Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER