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General NPI Number Information
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NPI Number | 1174562342
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Entity Type | Individual
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Provider Name | STEPHANIE BAKYTA LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 21 DELAWARE AVE
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-1403
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Country | US
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Telephone | 518-752-5605
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Fax | 518-921-4469
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Provider Business Mailing Address
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Address Line | 51 S HOLLYWOOD AVE
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-4112
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Country | US
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Telephone | 518-752-5605
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Fax | 518-921-4469
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R073012-1
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License Number State | NY
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