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General NPI Number Information
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NPI Number | 1063560365
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Entity Type | Individual
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Provider Name | STEPHEN KING LANDER LMFT
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 71687 HIGHWAY 111 STE 205
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4515
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Country | US
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Telephone | 612-205-4576
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Fax |
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Provider Business Mailing Address
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Address Line | 796 N SEVILLE CIR
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City | PALM SPRINGS
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State | CA
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Zip | 92262-6242
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Country | US
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Telephone | 612-205-4576
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMFT #834
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MA LP #3316
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 20572
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License Number State | CA
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