Basic Information
Provider Information | |||||||||
NPI: | 1033328000 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STENZEL | ||||||||
FirstName: | TERESA | ||||||||
MiddleName: | E | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | LSCSW | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | COPELAND | ||||||||
OtherFirstName: | TERESA | ||||||||
OtherMiddleName: | E | ||||||||
OtherNamePrefix: | MS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | LSCSW | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 205 E. 7TH STREET SUITE 265 | ||||||||
Address2: | PO BOX 1623 | ||||||||
City: | HAYS | ||||||||
State: | KS | ||||||||
PostalCode: | 67601 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7857980850 | ||||||||
FaxNumber: | 3162839540 | ||||||||
Practice Location | |||||||||
Address1: | 205 E. 7TH STREET SUITE 265 | ||||||||
Address2: |   | ||||||||
City: | HAYS | ||||||||
State: | KS | ||||||||
PostalCode: | 67601 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7857980850 | ||||||||
FaxNumber: | 3162839540 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/22/2007 | ||||||||
LastUpdateDate: | 12/23/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 12/23/2019 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LSCSW3916 | KS | Y |   | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | LMSW 6106 | KS | N |   | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.