Provider Demographics
NPI:1891517421
Name:PALTOS, STEPHANIE (LAC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:PALTOS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 MAIN ST FL 1
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-1603
Mailing Address - Country:US
Mailing Address - Phone:570-534-0324
Mailing Address - Fax:
Practice Address - Street 1:919 MAIN ST FL 1
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-1603
Practice Address - Country:US
Practice Address - Phone:570-534-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00784000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional