MEDICARE: STEPHANI TERESA HALLADAY LCPC

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	CP5337	NV

General Provider Information

NPI Number	:	1720743016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANI TERESA HALLADAY LCPC

Provider Business Mailing Address
First Line	:	1419 LEONARD RD
Second Line	:
City	:	GARDNERVILLE
State	:	NV
Zip	:	89460-8335
Country	:	US
Telephone Number	:	775-401-0010
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 LUCERNE ST STE 205
Second Line	:
City	:	MINDEN
State	:	NV
Zip	:	89423-4312
Country	:	US
Telephone Number	:	775-461-5178
Fax Number	:

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

Provider Enumeration Date	:	11/02/2021
Last Update Date	:	11/11/2025

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