Provider Demographics
NPI:1184891640
Name:MCLEESE-GRIFFIN, STEPHANIE EBERS (MA)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:EBERS
Last Name:MCLEESE-GRIFFIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5943 ARROW WOOD RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68526-9513
Mailing Address - Country:US
Mailing Address - Phone:402-540-0298
Mailing Address - Fax:
Practice Address - Street 1:2300 S 16TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3780
Practice Address - Country:US
Practice Address - Phone:140-254-0029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE889101YA0400X
NE1917101YP2500X
NE3867101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1002559600Medicaid