Provider Demographics
NPI:1023519147
Name:FALOTICO, STEPHANIE (LMSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FALOTICO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42850 SCHOENHERR RD STE 4
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-2875
Mailing Address - Country:US
Mailing Address - Phone:586-209-3929
Mailing Address - Fax:
Practice Address - Street 1:42850 SCHOENHERR RD STE 4
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-2875
Practice Address - Country:US
Practice Address - Phone:586-209-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010981961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical