Provider Demographics
NPI:1104308246
Name:METZGER, STEFANIE (CSW)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:METZGER
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8140 DREAM ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-7531
Mailing Address - Country:US
Mailing Address - Phone:859-739-0432
Mailing Address - Fax:
Practice Address - Street 1:8140 DREAM ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-7531
Practice Address - Country:US
Practice Address - Phone:859-739-0432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2535431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical