MEDICARE: STEPHANIE CAWLEY LMHC

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
1	101YM0800X	Mental Health Counselor	011786	NY

General Provider Information

NPI Number	:	1508503491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE CAWLEY LMHC

Provider Business Mailing Address
First Line	:	521 W MANCHESTER RD
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13219-2419
Country	:	US
Telephone Number	:	315-723-4312
Fax Number	:

Provider Business Practice Location Address
First Line	:	521 W MANCHESTER RD
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13219-2419
Country	:	US
Telephone Number	:	315-723-4312
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2022
Last Update Date	:	10/07/2025

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