Healthcare Provider Details

I. General information

NPI: 1952726176
Provider Name (Legal Business Name): CINDY STOFFREGEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2014
Last Update Date: 02/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2868 ACTON RD
VESTAVIA AL
35243-2502
US

IV. Provider business mailing address

2868 ACTON RD
VESTAVIA AL
35243-2502
US

V. Phone/Fax

Practice location:
  • Phone: 205-968-8360
  • Fax: 205-968-8374
Mailing address:
  • Phone: 205-968-8360
  • Fax: 205-968-8374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1918
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2105
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: