Healthcare Provider Details

I. General information

NPI: 1538145537
Provider Name (Legal Business Name): STEPHANIE J. KLOPFER MED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 COMMUNITY
CLINTON MO
64735-8804
US

IV. Provider business mailing address

320 MAC BLVD
NEVADA MO
64772-3990
US

V. Phone/Fax

Practice location:
  • Phone: 660-890-8183
  • Fax: 816-318-3109
Mailing address:
  • Phone: 417-667-2262
  • Fax: 417-667-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2000169031
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: