Provider Demographics
NPI:1578820890
Name:HOMES, STEPHANIE ALICE (LMSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ALICE
Last Name:HOMES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-5269
Mailing Address - Country:US
Mailing Address - Phone:734-635-4570
Mailing Address - Fax:
Practice Address - Street 1:802 MONROE ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-5269
Practice Address - Country:US
Practice Address - Phone:734-635-4570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical