Kidd, Stephanie L

Kidd, Stephanie L is an individual health care provider with primary practice located at 6929 W 130Th St Suite 503, Cleveland OH 44130-7895. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Kidd, Stephanie L can be contacted via phone (440) 481-3055.

Contact Information

Primary practice address
6929 W 130Th St Suite 503 Cleveland OH 44130-7895
Phone: (440) 481-3055
Fax: (440) 481-3222
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X E0007819 Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X E0007819 Ohio

Profile Details

NPI number 1801976634
LBN Legal business name Kidd, Stephanie L
Credentials MA, MED, LPCC/PCC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Oct 23rd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801976634 NPPES
Ohio Other 587502 PROVIDER VO ID#
Ohio Other 393335 PROVIDER VO ID#
Ohio Other 2908413 PROVIDER VO ID#
Ohio MEDICAID 2967384 PROVIDER VO ID#

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