Provider Demographics
NPI:1891318473
Name:CADELIEN, STEPHANIE (LGPC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CADELIEN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 WAYNE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4450
Mailing Address - Country:US
Mailing Address - Phone:301-804-3055
Mailing Address - Fax:
Practice Address - Street 1:801 WAYNE AVE STE 204
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4450
Practice Address - Country:US
Practice Address - Phone:301-804-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLGP10465OtherPRIVATE INSURANCE