Provider Demographics
NPI:1285305896
Name:PIERCE, STEPHANIE N (LMSW)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:N
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21234 TIFFANY DR
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1620
Mailing Address - Country:US
Mailing Address - Phone:734-629-2475
Mailing Address - Fax:
Practice Address - Street 1:21234 TIFFANY DR
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-1620
Practice Address - Country:US
Practice Address - Phone:734-629-2475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010974731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical