Provider Demographics
NPI:1023775533
Name:STEIN, CAROLINE FAY (LPC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:FAY
Last Name:STEIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1115
Mailing Address - Country:US
Mailing Address - Phone:215-808-4224
Mailing Address - Fax:215-808-4224
Practice Address - Street 1:7520 STATE RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-3411
Practice Address - Country:US
Practice Address - Phone:215-808-4224
Practice Address - Fax:215-808-4224
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002905101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional