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NPI Code Detail

MEDICARE: DR. STEPHANIE MARIE COONS DSW

MEDICARE: DR. STEPHANIE MARIE COONS DSW
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 Worker7818-123WI

General Provider Information

NPI Number : 1467733576
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHANIE MARIE COONS DSW
Provider Business Mailing Address
First Line : 5718 RURAL EDGE DR
Second Line :
City : ROSCOE
State : IL
Zip : 61073-7989
Country : US
Telephone Number : 815-391-3349
Fax Number :
Provider Business Practice Location Address
First Line : 3144 VANZILE RD
Second Line :
City : CRANDON
State : WI
Zip : 54520-8149
Country : US
Telephone Number : 715-478-5180
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2011
Last Update Date : 11/24/2025

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