Provider Demographics
NPI:1457590135
Name:HANDEL, STEPHANIE GAIL
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:GAIL
Last Name:HANDEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 CONNECTICUIT AVENUE NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-1162
Mailing Address - Country:US
Mailing Address - Phone:202-624-0010
Mailing Address - Fax:202-624-0062
Practice Address - Street 1:4201 CONNECTICUIT AVENUE NW
Practice Address - Street 2:SUITE 300
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1162
Practice Address - Country:US
Practice Address - Phone:202-624-0010
Practice Address - Fax:202-624-0062
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG1016661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC037516200Medicaid