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General NPI Number Information
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NPI Number | 1396272951
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Entity Type | Individual
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Provider Name | STEPHANIE C LANIEWSKI CGC
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Gender | Female
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Dates
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Enumeration Date | 05/15/2017
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Last Update Date | 07/15/2024
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Provider Practice Location Address
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Address Line | 611 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2501
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Country | US
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Telephone | 217-383-4930
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Fax |
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Provider Business Mailing Address
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Address Line | 611 W PARK ST FAPC
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City | URBANA
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State | IL
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Zip | 61801-2500
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 246000864
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | NULL
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