Provider Demographics
NPI:1972280584
Name:WILLIN, STEPHANIE (LMSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WILLIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 SEASHORE HWY
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19933-3109
Mailing Address - Country:US
Mailing Address - Phone:410-422-0886
Mailing Address - Fax:
Practice Address - Street 1:16287 WILLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-3614
Practice Address - Country:US
Practice Address - Phone:410-422-0886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0011165104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker