Provider Demographics
NPI:1871215517
Name:HERVEY, STEPHANIE (LMHC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HERVEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-0088
Mailing Address - Country:US
Mailing Address - Phone:914-462-8406
Mailing Address - Fax:
Practice Address - Street 1:116 SOUNDVIEW AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1421
Practice Address - Country:US
Practice Address - Phone:914-462-8406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011815101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health