Healthcare Provider Details

I. General information

NPI: 1942454707
Provider Name (Legal Business Name): STEFANIE HAYS NOLDER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2134 MONTEBELLO CT
TALLAHASSEE FL
32317-7938
US

IV. Provider business mailing address

2911 ROBERTS AVE
TALLAHASSEE FL
32310-5007
US

V. Phone/Fax

Practice location:
  • Phone: 850-933-8460
  • Fax:
Mailing address:
  • Phone: 850-645-6667
  • Fax: 855-230-7421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW9074
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: