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NPI Code Detail

MEDICARE: MRS. STEPHANIE A MAASS MS, LAC

MEDICARE: MRS. STEPHANIE A MAASS MS, LAC
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 CounselorA2511008AR

General Provider Information

NPI Number : 1205794211
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE A MAASS MS, LAC
Provider Business Mailing Address
First Line : 11399 MILL DAM RD
Second Line :
City : BENTONVILLE
State : AR
Zip : 72713-2702
Country : US
Telephone Number : 479-409-0067
Fax Number :
Provider Business Practice Location Address
First Line : 2105 S 54TH ST STE 2
Second Line :
City : ROGERS
State : AR
Zip : 72758-8191
Country : US
Telephone Number : 479-268-4557
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2026
Last Update Date : 01/10/2026

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