White Eagle, Stephanie Lynn

White Eagle, Stephanie Lynn is an individual health care provider with primary practice located at S2845 White Eagle Rd , Baraboo WI 53913-9064. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. White Eagle, Stephanie Lynn can be contacted via phone (608) 355-1240.

Contact Information

Primary practice address
S2845 White Eagle Rd Baraboo WI 53913-9064
Phone: (608) 355-1240
Fax: (608) 356-7152
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 11480-132 Wisconsin
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 1258-124 Wisconsin

Profile Details

NPI number 1184957334
LBN Legal business name White Eagle, Stephanie Lynn
Credentials MFT,CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2009
Last updated Oct 24th, 2019 - about 7 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 1184957334 NPPES
Wisconsin MEDICAID 1184957334

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