Provider Demographics
NPI:1790579936
Name:ALMANZA, STEPHANIE (LGSW, LADC, ICGC-I)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ALMANZA
Suffix:
Gender:
Credentials:LGSW, LADC, ICGC-I
Other - Prefix:
Other - First Name:STEPH
Other - Middle Name:
Other - Last Name:ALMANZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LGSW
Mailing Address - Street 1:215 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56241-1431
Mailing Address - Country:US
Mailing Address - Phone:218-731-8251
Mailing Address - Fax:
Practice Address - Street 1:215 10TH AVE
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56241-1431
Practice Address - Country:US
Practice Address - Phone:218-731-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306201101YA0400X
MN336901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty