Healthcare Provider Details

I. General information

NPI: 1578814240
Provider Name (Legal Business Name): STEVIE TABOR STIGLER LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2012
Last Update Date: 02/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CARLTON ST
ATHENS GA
30602-1503
US

IV. Provider business mailing address

55 CARLTON ST
ATHENS GA
30602-1503
US

V. Phone/Fax

Practice location:
  • Phone: 706-542-2273
  • Fax: 706-542-8661
Mailing address:
  • Phone: 706-542-2273
  • Fax: 706-542-8661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0006964
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: