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General NPI Number Information
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NPI Number | 1356710669
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Entity Type | Individual
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Provider Name | STEPHANIE VITTITOE LPCC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 401 E WASHINGTON ST
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City | GEORGETOWN
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State | KY
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Zip | 40324-2161
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Country | US
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Telephone | 502-724-9093
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Fax |
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Provider Business Mailing Address
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Address Line | 101 ARROWHEAD CT
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City | GEORGETOWN
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State | KY
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Zip | 40324-8971
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Country | US
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Telephone |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPCCCA00220350
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 260205
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License Number State | KY
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