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General NPI Number Information
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NPI Number | 1639336191
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Entity Type | Individual
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Provider Name | STEPHANIE L PETERS LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 400 POPLAR ST
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City | MACON
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State | GA
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Zip | 31201-3336
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Country | US
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Telephone | 478-787-4266
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Fax |
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Provider Business Mailing Address
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Address Line | 428 COLUMBUS AVE
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City | NEW HAVEN
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State | CT
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Zip | 06519-1233
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Country | US
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Telephone | 203-503-3055
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Fax | 203-503-3066
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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