MEDICARE: STEPHANIE PALTOS LAC

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	101YP2500X	Professional Counselor	37AC00784000	NJ

General Provider Information

NPI Number	:	1891517421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE PALTOS LAC

Provider Business Mailing Address
First Line	:	919 MAIN ST FL 1
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-1603
Country	:	US
Telephone Number	:	570-534-0324
Fax Number	:

Provider Business Practice Location Address
First Line	:	919 MAIN ST FL 1
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-1603
Country	:	US
Telephone Number	:	570-534-0324
Fax Number	:

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

Provider Enumeration Date	:	10/25/2024
Last Update Date	:	10/25/2024

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Directions to “ STEPHANIE PALTOS LAC” Practice Location

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