Provider Demographics
NPI:1356520316
Name:WEATHERSBEE, STEPHEN LOUIS (LMFT)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LOUIS
Last Name:WEATHERSBEE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1175
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:96008-1175
Mailing Address - Country:US
Mailing Address - Phone:530-722-5212
Mailing Address - Fax:
Practice Address - Street 1:2143 AIRPARK DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2433
Practice Address - Country:US
Practice Address - Phone:530-722-5212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 48324106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist