Provider Demographics
NPI:1447569603
Name:ALLEN, STEPHANIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25757 SUMMERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-5201
Mailing Address - Country:US
Mailing Address - Phone:256-341-0811
Mailing Address - Fax:256-341-9358
Practice Address - Street 1:224 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-2344
Practice Address - Country:US
Practice Address - Phone:256-341-0811
Practice Address - Fax:256-341-9358
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2840101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional