Provider Demographics
NPI:1649356379
Name:SLYE, STEPHANIE MERKEY (PSYD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MERKEY
Last Name:SLYE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MEAGAN
Other - Last Name:MERKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 NILES RD STE 5
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-3225
Mailing Address - Country:US
Mailing Address - Phone:269-281-0408
Mailing Address - Fax:269-281-4065
Practice Address - Street 1:2500 NILES RD STE 5
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-3225
Practice Address - Country:US
Practice Address - Phone:269-281-0408
Practice Address - Fax:269-281-4065
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2980103TC0700X
NY016982103TC0700X
MI6301013866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical