Provider Demographics
NPI:1821753963
Name:FIERRO, STEPHANIE (MENTAL HEALTH COUNSE)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FIERRO
Suffix:
Gender:F
Credentials:MENTAL HEALTH COUNSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-2908
Mailing Address - Country:US
Mailing Address - Phone:917-942-0844
Mailing Address - Fax:
Practice Address - Street 1:216 E 45TH ST RM 1101
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3304
Practice Address - Country:US
Practice Address - Phone:212-960-8626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health