Basic Information
| Provider Information | |||||||||
| NPI: | 1891251229 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARTEL | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | TRUSCHEL | ||||||||
| OtherFirstName: | STEPHANIE | ||||||||
| OtherMiddleName: | ELIZABETH | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 1927 | ||||||||
| Address2: | |||||||||
| City: | BIG BEAR LAKE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923151927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098665070 | ||||||||
| FaxNumber: | 9098783228 | ||||||||
| Practice Location | |||||||||
| Address1: | 41945 BIG BEAR BLVD | ||||||||
| Address2: | SUITES 221, 222, 223 | ||||||||
| City: | BIG BEAR LAKE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923151927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9098665070 | ||||||||
| FaxNumber: | 9098783228 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2019 | ||||||||
| LastUpdateDate: | 02/11/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.