Provider Demographics
NPI:1457975468
Name:STCLOUD, STEPHANIE JENNY (MSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JENNY
Last Name:STCLOUD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2764 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1336
Mailing Address - Country:US
Mailing Address - Phone:545-882-2284
Mailing Address - Fax:
Practice Address - Street 1:2764 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1336
Practice Address - Country:US
Practice Address - Phone:954-588-2284
Practice Address - Fax:954-306-2056
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-05
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker