Provider Demographics
NPI:1881723518
Name:MINTER, STEPHANIE D (LCSWR)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:D
Last Name:MINTER
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:D
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1835
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562
Mailing Address - Country:US
Mailing Address - Phone:914-374-5124
Mailing Address - Fax:914-923-0523
Practice Address - Street 1:79 CROTON AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562
Practice Address - Country:US
Practice Address - Phone:914-923-0523
Practice Address - Fax:914-923-0523
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0532621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical