Healthcare Provider Details

I. General information

NPI: 1114866795
Provider Name (Legal Business Name): STEPHANIE EPDING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 HONEYSUCKLE RD STE 12
DOTHAN AL
36305-1168
US

IV. Provider business mailing address

403 OAKWOOD DR
DOTHAN AL
36303-3085
US

V. Phone/Fax

Practice location:
  • Phone: 334-792-6736
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC05961
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: