Healthcare Provider Details

I. General information

NPI: 1184467508
Provider Name (Legal Business Name): STEPHANIE LYNN LIGMAN APSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 POST RD
STEVENS POINT WI
54481-6134
US

IV. Provider business mailing address

110 DEWEY DR
STEVENS POINT WI
54482-9654
US

V. Phone/Fax

Practice location:
  • Phone: 855-607-8242
  • Fax:
Mailing address:
  • Phone: 715-340-3125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number134889-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: