Provider Demographics
NPI:1336542323
Name:STERMENSKY, GAGE II (PSYD, BCB)
Entity Type:Individual
Prefix:DR
First Name:GAGE
Middle Name:
Last Name:STERMENSKY
Suffix:II
Gender:M
Credentials:PSYD, BCB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1723 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-2446
Mailing Address - Country:US
Mailing Address - Phone:417-413-0085
Mailing Address - Fax:
Practice Address - Street 1:1723 AVENUE A
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-2446
Practice Address - Country:US
Practice Address - Phone:417-413-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE885103T00000X
NE987101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)