Provider Demographics
NPI:1720771462
Name:BIANCO, STEPHANIE RENAE (PLADC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:RENAE
Last Name:BIANCO
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3716
Mailing Address - Country:US
Mailing Address - Phone:531-205-3084
Mailing Address - Fax:
Practice Address - Street 1:2670 COUNTY ROAD 57
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-6051
Practice Address - Country:US
Practice Address - Phone:308-313-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-2075101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)