Provider Demographics
NPI:1326470071
Name:STINEBAUGH, JOHN F (MA, LMFT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:STINEBAUGH
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3730
Mailing Address - Country:US
Mailing Address - Phone:307-216-4227
Mailing Address - Fax:
Practice Address - Street 1:1904 WARREN AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3730
Practice Address - Country:US
Practice Address - Phone:307-216-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLMFT-211106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist