Provider Demographics
NPI:1699766071
Name:STEMPLE, J. EDWARD (LCSW)
Entity type:Individual
Prefix:MR
First Name:J. EDWARD
Middle Name:
Last Name:STEMPLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 ROLLING ACRES RD
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-4714
Mailing Address - Country:US
Mailing Address - Phone:724-532-1618
Mailing Address - Fax:
Practice Address - Street 1:315 DEPOT ST
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1560
Practice Address - Country:US
Practice Address - Phone:724-532-1618
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW003996L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA109586OtherVALUE OPTIONS
PA1047634OtherCIGNA BEHAVORIAL HEALTH,