Provider Demographics
NPI:1871981548
Name:STEFFENSEN, TALIA ELISABETH (MS, LPC)
Entity type:Individual
Prefix:
First Name:TALIA
Middle Name:ELISABETH
Last Name:STEFFENSEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 MUIRFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-6985
Mailing Address - Country:US
Mailing Address - Phone:610-573-4913
Mailing Address - Fax:
Practice Address - Street 1:162 MUIRFIELD WAY
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-6985
Practice Address - Country:US
Practice Address - Phone:610-573-4913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1OtherBLUE CROSS
PA2Medicaid
PA1OtherBLUE CROSS
5Medicare UPIN
PA6Medicare UPIN
PA2Medicaid