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General NPI Number Information
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NPI Number | 1649759192
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Entity Type | Individual
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Provider Name | STEPHANIE JEAN LYON-STIRLING PHD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 3-5 VOSE AVE STE 6
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-2006
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Country | US
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Telephone | 973-498-8344
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Fax |
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Provider Business Mailing Address
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Address Line | 27 COLLINWOOD RD
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-1035
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Country | US
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Telephone | 201-874-5109
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 022455
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00584100
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License Number State | NJ
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