Provider Demographics
NPI:1588256838
Name:PAIDAS, STEPHANIE M (PHD, LCPC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:M
Last Name:PAIDAS
Suffix:
Gender:F
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4763
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-4763
Mailing Address - Country:US
Mailing Address - Phone:406-890-4990
Mailing Address - Fax:
Practice Address - Street 1:100 2ND ST E STE 320
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2410
Practice Address - Country:US
Practice Address - Phone:406-890-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-24042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional