Provider Demographics
NPI:1629491683
Name:KRIESCHER, STEPHANIE LEANDRA (PHD LP NCSP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEANDRA
Last Name:KRIESCHER
Suffix:
Gender:
Credentials:PHD LP NCSP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:LEANDRA
Other - Last Name:STRASBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:363 W DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6323
Mailing Address - Country:US
Mailing Address - Phone:970-465-2977
Mailing Address - Fax:
Practice Address - Street 1:363 W DRAKE RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6323
Practice Address - Country:US
Practice Address - Phone:970-465-2977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0005732103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist