Basic Information
Provider Information | |||||||||
NPI: | 1043643711 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STOEHR | ||||||||
FirstName: | TONIA | ||||||||
MiddleName: | JOELL | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | LMSW | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | ALLAN | ||||||||
OtherFirstName: | TONIA | ||||||||
OtherMiddleName: | JOELL | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 715 HORIZON DR | ||||||||
Address2: | STE 225 | ||||||||
City: | GRAND JUNCTION | ||||||||
State: | CO | ||||||||
PostalCode: | 815068700 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9706837107 | ||||||||
FaxNumber: | 9706837167 | ||||||||
Practice Location | |||||||||
Address1: | 407 S LINCOLN AVE | ||||||||
Address2: |   | ||||||||
City: | STEAMBOAT SPRINGS | ||||||||
State: | CO | ||||||||
PostalCode: | 80487 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9708792141 | ||||||||
FaxNumber: | 9708797912 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/16/2013 | ||||||||
LastUpdateDate: | 08/16/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X |   |   | Y |   | Behavioral Health & Social Service Providers | Counselor | Mental Health | 104100000X | 3301 | KS | N |   | Behavioral Health & Social Service Providers | Social Worker |   |
No ID Information.