Provider Demographics
NPI:1669800314
Name:STEPANIAN, IVA JANETTE (MA, NCC,LPC)
Entity type:Individual
Prefix:
First Name:IVA
Middle Name:JANETTE
Last Name:STEPANIAN
Suffix:
Gender:F
Credentials:MA, NCC,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 NORTHVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1115
Mailing Address - Country:US
Mailing Address - Phone:724-622-5086
Mailing Address - Fax:
Practice Address - Street 1:121 NORTHVIEW CIR
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1115
Practice Address - Country:US
Practice Address - Phone:724-622-5086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006590101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health