Provider Demographics
NPI:1942551759
Name:HANNEKEN, STEPHANIE DIANE (MA, LPC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DIANE
Last Name:HANNEKEN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:DIANE
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, PLPC
Mailing Address - Street 1:16020 SWINGLEY RIDGE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2085
Mailing Address - Country:US
Mailing Address - Phone:314-252-8683
Mailing Address - Fax:
Practice Address - Street 1:16020 SWINGLEY RIDGE RD STE 305
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2085
Practice Address - Country:US
Practice Address - Phone:314-252-8683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012032155101YM0800X, 101YP2500X
AZLPC-18512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health