Provider Demographics
NPI:1982029088
Name:JAMES, STEPHANIE MERLE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MERLE
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:JAMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCP, LCPC
Mailing Address - Street 1:1522 N BEND RD
Mailing Address - Street 2:
Mailing Address - City:JARRETTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21084-1332
Mailing Address - Country:US
Mailing Address - Phone:410-409-5973
Mailing Address - Fax:
Practice Address - Street 1:1522 N BEND RD
Practice Address - Street 2:
Practice Address - City:JARRETTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21084-1332
Practice Address - Country:US
Practice Address - Phone:410-409-5973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional