Provider Demographics
NPI:1851627202
Name:SUNDSETH, STEPHANIE BETH (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:BETH
Last Name:SUNDSETH
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 1:4111 EAST VALLEY AUTO DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4605
Mailing Address - Country:US
Mailing Address - Phone:480-250-3403
Mailing Address - Fax:
Practice Address - Street 1:4111 EAST VALLEY AUTO DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4605
Practice Address - Country:US
Practice Address - Phone:480-250-3403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional