Basic Information
| Provider Information | |||||||||
| NPI: | 1114152162 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STENDER | ||||||||
| FirstName: | JOELLEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.S., LMHC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DINSE | ||||||||
| OtherFirstName: | JOELLEN | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.S | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 458 | ||||||||
| Address2: | 2107 SPRUCE STREET | ||||||||
| City: | NORTH COLLINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141110458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163373706 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2107 SPRUCE STREET | ||||||||
| Address2: | |||||||||
| City: | NORTH COLLINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 141110458 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163373706 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2009 | ||||||||
| LastUpdateDate: | 07/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 004866 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.