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NPI Code Detail

MEDICARE: DR. ANGELA MICHELLE STEBBINS PSY.D.

MEDICARE: DR. ANGELA MICHELLE STEBBINS PSY.D.
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
1103T00000XPsychologist3154-57WI
2103T00000XPsychologist6301019181MI

General Provider Information

NPI Number : 1609178193
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA MICHELLE STEBBINS PSY.D.
Provider Business Mailing Address
First Line : 4305 N LINCOLN AVE
Second Line : STE M
City : CHICAGO
State : IL
Zip : 60618-1807
Country : US
Telephone Number : 872-216-7743
Fax Number : 855-727-4855
Provider Business Practice Location Address
First Line : 1401 PRESQUE ISLE AVE
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-2818
Country : US
Telephone Number : 906-227-2980
Fax Number : 855-727-4855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2010
Last Update Date : 12/12/2024

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