Provider Demographics
NPI:1699284539
Name:YANEY, STEPHANIE M (BA, MSW, LSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:YANEY
Suffix:
Gender:F
Credentials:BA, MSW, LSW
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 631
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-0631
Mailing Address - Country:US
Mailing Address - Phone:937-423-6396
Mailing Address - Fax:937-339-7816
Practice Address - Street 1:550 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-3047
Practice Address - Country:US
Practice Address - Phone:937-335-0361
Practice Address - Fax:937-339-7816
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 390200000X
OHS.2309016104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program