Provider Demographics
NPI:1720799901
Name:OPPENHEIM, STACY (LCMHCA)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:OPPENHEIM
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 PARKWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17103-2049
Mailing Address - Country:US
Mailing Address - Phone:570-817-6817
Mailing Address - Fax:
Practice Address - Street 1:1108 NEW POINTE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-1279
Practice Address - Country:US
Practice Address - Phone:570-817-6817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor