MEDICARE: STEPHANIE WAHL COUNSELING AND CONSULTATION

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1851281935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHANIE WAHL COUNSELING AND CONSULTATION

Provider Business Mailing Address
First Line	:	4180 SALT CREEK DR
Second Line	:
City	:	DUNCAN FALLS
State	:	OH
Zip	:	43734-9719
Country	:	US
Telephone Number	:	740-280-6980
Fax Number	:

Provider Business Practice Location Address
First Line	:	4509 SALT CREEK DR
Second Line	:
City	:	DUNCAN FALLS
State	:	OH
Zip	:	43734-9733
Country	:	US
Telephone Number	:	740-221-3026
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR/ OWNER
Name	:	STEPHANIE WAHL
Credential	:	LISW-S
Telephone Number	:	740-280-6980

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	07/08/2025

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