Healthcare Provider Details
I. General information
NPI: 1386065209
Provider Name (Legal Business Name): STEPHANIE A DEPALMER ED.D., LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/18/2013
Last Update Date: 04/11/2024
Certification Date: 04/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
158 GARDNER ROAD
MARKLETON PA
15551-8904
US
IV. Provider business mailing address
158 GARDNER ROAD
MARKLETON PA
15551-8904
US
V. Phone/Fax
- Phone: 814-279-8274
- Fax:
- Phone: 814-279-8274
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PC008006 |
| License Number State | PA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: