MEDICARE: STEPHANIE J WARNOCK L.C.S.W.

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
1	1041C0700X	Clinical Social Worker	250	AK

General Provider Information

NPI Number	:	1639104185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE J WARNOCK L.C.S.W.

Provider Business Mailing Address
First Line	:	4048 LAUREL ST
Second Line	:	STE 305
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5391
Country	:	US
Telephone Number	:	907-561-0044
Fax Number	:	907-561-5478

Provider Business Practice Location Address
First Line	:	4048 LAUREL ST
Second Line	:	STE 305
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5391
Country	:	US
Telephone Number	:	907-561-0044
Fax Number	:	907-561-5478

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	09/28/2018

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