Provider Demographics
NPI:1194090993
Name:PAVLOSKI, STEFANIE (LLPC)
Entity type:Individual
Prefix:MS
First Name:STEFANIE
Middle Name:
Last Name:PAVLOSKI
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 BOW POINTE DR STE 380
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-5406
Mailing Address - Country:US
Mailing Address - Phone:248-241-6514
Mailing Address - Fax:248-241-6639
Practice Address - Street 1:5701 BOW POINTE DR., STE. #380
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346
Practice Address - Country:US
Practice Address - Phone:248-241-6514
Practice Address - Fax:248-241-6639
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health