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1609178193 NPI number — ANGELA MICHELLE STEBBINS PSY.D.

NPI Number: 1609178193
Health Care Provider/Practitioner: ANGELA MICHELLE STEBBINS PSY.D.

Information about “1609178193” NPI (ANGELA MICHELLE STEBBINS PSY.D.) exists in 1609178193 in HTML format HTML  |  1609178193 in plain Text format TXT  |  1609178193 in PDF (Portable Document Format) PDF  |  1609178193 in an XML format XML  formats.

NPI Number : 1609178193 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609178193",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STEBBINS",
    "FirstName": "ANGELA",
    "MiddleName": "MICHELLE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PSY.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "HANCHETT",
    "OtherFirstName": "ANGELA",
    "OtherMiddleName": "MICHELLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PSY.D.",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "4305 N LINCOLN AVE",
    "SecondLineMailingAddress": "STE M",
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60618-1807",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "872-216-7743",
    "MailingAddressFaxNumber": "855-727-4855",
    "FirstLinePracticeLocationAddress": "1401 PRESQUE ISLE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MARQUETTE",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49855-2818",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "906-227-2980",
    "PracticeLocationAddressFaxNumber": "855-727-4855",
    "EnumerationDate": "12/03/2010",
    "LastUpdateDate": "12/12/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "3154-57",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "6301019181",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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