Provider Demographics
NPI:1528160009
Name:BILLMAN, STEPHANIE SHAYNE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:SHAYNE
Last Name:BILLMAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4889 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-7295
Mailing Address - Country:US
Mailing Address - Phone:602-743-6131
Mailing Address - Fax:480-545-6773
Practice Address - Street 1:3303 E BASELINE RD STE 114 BLDG 6
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2740
Practice Address - Country:US
Practice Address - Phone:602-743-6131
Practice Address - Fax:480-545-6773
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10666101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health