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General NPI Number Information
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NPI Number | 1184452534
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Entity Type | Individual
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Provider Name | STEPHANIE FOUGHT
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Gender | Female
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 7717 N ORANGE PRAIRIE RD
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City | PEORIA
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State | IL
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Zip | 61615-9323
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Country | US
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Telephone | 217-920-7299
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Fax |
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Provider Business Mailing Address
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Address Line | 61 RAN RUE DR
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City | MARTINSBURG
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State | WV
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Zip | 25403-1608
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Country | US
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Telephone | 573-318-5394
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 31155
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | BP00947201
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.116520
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License Number State | IL
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