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NPI Code Detail

MEDICARE: MISS STEPHANIE DIANE SANCHEZ MSW, LCSW

MEDICARE: MISS STEPHANIE DIANE SANCHEZ MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker34006378AIN

General Provider Information

NPI Number : 1003011727
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS STEPHANIE DIANE SANCHEZ MSW, LCSW
Provider Business Mailing Address
First Line : 240 N TILLOTSON AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-3988
Country : US
Telephone Number : 765-288-1928
Fax Number : 765-741-0335
Provider Business Practice Location Address
First Line : 2506 WILLOWBROOK PKWY STE 300
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46205-1500
Country : US
Telephone Number : 317-574-1254
Fax Number : 317-674-0060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 07/21/2022

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