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NPI Code Detail

MEDICARE: MRS. JENNIFER S STEFANOVSKI LPC

MEDICARE: MRS. JENNIFER S STEFANOVSKI 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
1101YM0800XMental Health CounselorE1200662OH
2101YM0800XMental Health Counselor39005494AIN

General Provider Information

NPI Number : 1558739755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER S STEFANOVSKI LPC
Provider Business Mailing Address
First Line : 3301 W PURDUE AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-6356
Country : US
Telephone Number : 765-284-0043
Fax Number : 765-284-4112
Provider Business Practice Location Address
First Line : 3301 W PURDUE AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-6356
Country : US
Telephone Number : 765-284-0043
Fax Number : 765-284-4112
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2015
Last Update Date : 07/09/2025

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