Provider Demographics
NPI:1427696251
Name:WHITE, STEPHANIE POPELKA (MS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:POPELKA
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 STRAWBERRY PLAINS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-3442
Mailing Address - Country:US
Mailing Address - Phone:757-291-1124
Mailing Address - Fax:
Practice Address - Street 1:500 STRAWBERRY PLAINS RD STE 101
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-3442
Practice Address - Country:US
Practice Address - Phone:757-291-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health