Provider Demographics
NPI:1194969535
Name:STANDEFER, STEPHANNEE R (LPC)
Entity type:Individual
Prefix:
First Name:STEPHANNEE
Middle Name:R
Last Name:STANDEFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E SCHAUMBURG RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3550
Mailing Address - Country:US
Mailing Address - Phone:847-981-3514
Mailing Address - Fax:847-230-3787
Practice Address - Street 1:25 E SCHAUMBURG RD
Practice Address - Street 2:SUITE 106
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3550
Practice Address - Country:US
Practice Address - Phone:847-981-3514
Practice Address - Fax:847-230-3787
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178006070101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health