Provider Demographics
NPI:1265570303
Name:TARAFDAR, STEPHANIE (PHD LMHC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:TARAFDAR
Suffix:
Gender:F
Credentials:PHD LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 NE 45TH ST
Mailing Address - Street 2:SUITE 121
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5131
Mailing Address - Country:US
Mailing Address - Phone:954-491-6163
Mailing Address - Fax:954-491-4255
Practice Address - Street 1:1919 NE 45TH ST
Practice Address - Street 2:SUITE 121
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5131
Practice Address - Country:US
Practice Address - Phone:954-491-6163
Practice Address - Fax:954-491-4255
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health