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General NPI Number Information
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NPI Number | 1659051001
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Entity Type | Individual
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Provider Name | STEPHANIE ANNE REICH FERMELIA LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 27601 FORBES RD STE 49
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-1242
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Country | US
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Telephone | 714-679-5814
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Fax |
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Provider Business Mailing Address
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Address Line | 23941 LEEWARD DR
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City | DANA POINT
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State | CA
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Zip | 92629-4453
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Country | US
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Telephone | 714-679-5814
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LCS20544
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License Number State | CA
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