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NPI Code Detail

MEDICARE: STEPHANIE MULLSTEFF LPC

MEDICARE: STEPHANIE MULLSTEFF LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor0701007148VA

General Provider Information

NPI Number : 1194240747
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE MULLSTEFF LPC
Provider Business Mailing Address
First Line : 10299 WOODMAN RD
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-4419
Country : US
Telephone Number : 804-727-8500
Fax Number : 804-727-8580
Provider Business Practice Location Address
First Line : 4825 S LABURNUM AVE
Second Line :
City : HENRICO
State : VA
Zip : 23231-2713
Country : US
Telephone Number : 804-727-8100
Fax Number : 804-727-8580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2017
Last Update Date : 08/04/2017

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Directions to “ STEPHANIE MULLSTEFF LPC” Practice Location

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