Provider Demographics
NPI:1912524422
Name:NALIBOTSKY, STEPHANIE NATTER (MA, ATRBC,CGP,LCPAT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:NATTER
Last Name:NALIBOTSKY
Suffix:
Gender:F
Credentials:MA, ATRBC,CGP,LCPAT
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:NATTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, ATRBC, CGP,LCPAT
Mailing Address - Street 1:10810 DARNESTOWN RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2604
Mailing Address - Country:US
Mailing Address - Phone:301-869-1017
Mailing Address - Fax:
Practice Address - Street 1:10810 DARNESTOWN RD STE 103
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2604
Practice Address - Country:US
Practice Address - Phone:301-869-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ATC127OtherLCPAT