Provider Demographics
NPI:1437977899
Name:CARMICHAEL, STEPHANIE LAMANDA
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LAMANDA
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 TEKE BURTON DR
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:IN
Mailing Address - Zip Code:47446-5397
Mailing Address - Country:US
Mailing Address - Phone:812-849-3834
Mailing Address - Fax:
Practice Address - Street 1:1081 TEKE BURTON DR
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:IN
Practice Address - Zip Code:47446-5397
Practice Address - Country:US
Practice Address - Phone:812-849-3834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool