Provider Demographics
NPI:1104238633
Name:STOFFERS, LINDSAY NICOLE (MS, PPC)
Entity type:Individual
Prefix:MISS
First Name:LINDSAY
Middle Name:NICOLE
Last Name:STOFFERS
Suffix:
Gender:F
Credentials:MS, PPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 E HARNEY ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-2644
Mailing Address - Country:US
Mailing Address - Phone:307-399-0788
Mailing Address - Fax:
Practice Address - Street 1:217 E GRAND AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3604
Practice Address - Country:US
Practice Address - Phone:307-399-0788
Practice Address - Fax:307-638-0394
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY836101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor