Provider Demographics
NPI:1790955698
Name:CZERNIEWSKI, STEFANIE (CRC)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:CZERNIEWSKI
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:STAATSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12580-5749
Mailing Address - Country:US
Mailing Address - Phone:845-889-4287
Mailing Address - Fax:
Practice Address - Street 1:26 OAKLEY ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2005
Practice Address - Country:US
Practice Address - Phone:845-486-3570
Practice Address - Fax:845-486-3599
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00041-135225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor