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NPI Code Detail

MEDICARE: STEPHANIE TWELLMAN LPC

MEDICARE: STEPHANIE TWELLMAN LPC
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
1101YM0800XMental Health CounselorC6919OR
2101YP2500XProfessional CounselorC6919OR

General Provider Information

NPI Number : 1013355601
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE TWELLMAN LPC
Provider Business Mailing Address
First Line : 1617 HAWTHORNE ST
Second Line :
City : FOREST GROVE
State : OR
Zip : 97116-2537
Country : US
Telephone Number : 714-566-4761
Fax Number :
Provider Business Practice Location Address
First Line : 8280 NE MAUZEY CT
Second Line :
City : HILLSBORO
State : OR
Zip : 97124-9092
Country : US
Telephone Number : 503-439-9531
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2013
Last Update Date : 11/25/2024

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