Provider Demographics
NPI:1386967230
Name:WOOLWORTH, STEPHANIE J (LPCI)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:J
Last Name:WOOLWORTH
Suffix:
Gender:F
Credentials:LPCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 36TH ST STE 210
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2069
Mailing Address - Country:US
Mailing Address - Phone:801-686-2099
Mailing Address - Fax:
Practice Address - Street 1:1140 36TH ST STE 210
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2069
Practice Address - Country:US
Practice Address - Phone:801-686-2099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-07
Last Update Date:2010-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health