Provider Demographics
NPI:1134268527
Name:EGBERS-MEYERS, STEPHANIE NICOLE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:NICOLE
Last Name:EGBERS-MEYERS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 SE POWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-3371
Mailing Address - Country:US
Mailing Address - Phone:971-295-9980
Mailing Address - Fax:503-813-7781
Practice Address - Street 1:3415 SE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3371
Practice Address - Country:US
Practice Address - Phone:503-307-7059
Practice Address - Fax:503-233-0187
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor