Provider Demographics
NPI:1922595248
Name:STEPHANIE LANCASTER LLC
Entity Type:Organization
Organization Name:STEPHANIE LANCASTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:614-385-2559
Mailing Address - Street 1:4773 CARROLL CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:OH
Mailing Address - Zip Code:43112-9428
Mailing Address - Country:US
Mailing Address - Phone:740-617-8162
Mailing Address - Fax:
Practice Address - Street 1:4773 CARROLL CEMETERY RD
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:OH
Practice Address - Zip Code:43112-9428
Practice Address - Country:US
Practice Address - Phone:740-617-8162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty