Provider Demographics
NPI:1023893047
Name:POWER, STEPHANIE (LMHCA, MACP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:POWER
Suffix:
Gender:F
Credentials:LMHCA, MACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38322 83RD AVE E
Mailing Address - Street 2:
Mailing Address - City:EATONVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98328-9070
Mailing Address - Country:US
Mailing Address - Phone:253-426-5519
Mailing Address - Fax:
Practice Address - Street 1:615 E PIONEER STE 204
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3320
Practice Address - Country:US
Practice Address - Phone:253-848-3891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61387902101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health