Provider Demographics
NPI:1992538425
Name:KAPINUS, STEFANIE KAE (PAT)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:KAE
Last Name:KAPINUS
Suffix:
Gender:F
Credentials:PAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 S DOUGLAS HWY
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-4027
Mailing Address - Country:US
Mailing Address - Phone:307-222-7952
Mailing Address - Fax:307-475-6019
Practice Address - Street 1:308 S DOUGLAS HWY
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4027
Practice Address - Country:US
Practice Address - Phone:307-222-7952
Practice Address - Fax:307-475-6019
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPAT095101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)