Provider Demographics
NPI:1992542088
Name:LEBARRE, STEFANIE E (LCSW)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:E
Last Name:LEBARRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 W DIMOND BLVD # 1124
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-1515
Mailing Address - Country:US
Mailing Address - Phone:813-364-9816
Mailing Address - Fax:
Practice Address - Street 1:901 N LEATHERLEAF LOOP STE 103
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-6576
Practice Address - Country:US
Practice Address - Phone:907-631-9365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW194281041C0700X
AK2134601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical