Provider Demographics
NPI:1043001415
Name:ROTTIER, STEPHANIE J (LPC-IT)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:J
Last Name:ROTTIER
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-4441
Mailing Address - Country:US
Mailing Address - Phone:920-634-2903
Mailing Address - Fax:844-380-1192
Practice Address - Street 1:123 S VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-4441
Practice Address - Country:US
Practice Address - Phone:920-634-2903
Practice Address - Fax:844-380-1192
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8323-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional