Provider Demographics
NPI:1710659875
Name:PERGANTIS, STEPHANIE I (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:I
Last Name:PERGANTIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 FRIDAY RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15209-2162
Mailing Address - Country:US
Mailing Address - Phone:412-848-7708
Mailing Address - Fax:
Practice Address - Street 1:300 S WALNUT LN STE 101&201
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1739
Practice Address - Country:US
Practice Address - Phone:412-888-3317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YS0200X
CO0013810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool