Provider Demographics
NPI:1770557282
Name:GALLOWAY-MASLANIK, STEPHANIE ANNE (LCSW, RPT-S)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ANNE
Last Name:GALLOWAY-MASLANIK
Suffix:
Gender:F
Credentials:LCSW, RPT-S
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ANNE
Other - Last Name:GALLOWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:6108 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:PA
Mailing Address - Zip Code:16611-2734
Mailing Address - Country:US
Mailing Address - Phone:814-386-0345
Mailing Address - Fax:
Practice Address - Street 1:1227 WARM SPRINGS AVE
Practice Address - Street 2:AMERICAN FAMILY C/O J.C. BLAIR MEMORIAL HOSPITAL
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2300
Practice Address - Country:US
Practice Address - Phone:814-386-0345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW123547104100000X
PACW0156921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA491062OtherMH NET
PA12286177OtherCAQH
PA001738891OtherHIGHMARK