Basic Information
| Provider Information | |||||||||
| NPI: | 1093869018 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERRINGTON | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1378 | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | MECCA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922541378 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603961249 | ||||||||
| FaxNumber: | 7603961253 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 E TAHQUITZ CANYON WAY | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603254088 | ||||||||
| FaxNumber: | 7607783781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 09/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS21973 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.