Provider Demographics
NPI:1114747714
Name:ONKST, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ONKST
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:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:GRAMPIAN
Mailing Address - State:PA
Mailing Address - Zip Code:16838-0106
Mailing Address - Country:US
Mailing Address - Phone:833-668-6861
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 106
Practice Address - Street 2:
Practice Address - City:GRAMPIAN
Practice Address - State:PA
Practice Address - Zip Code:16838-0106
Practice Address - Country:US
Practice Address - Phone:833-668-6861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-16
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017029101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health