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Individual
STEFANIE E RIDER
Active
Individual
STEFANIE E RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
39002259A
IN
101YM0800X
Mental Health Counselor
CTB-2022-0724
NM
101YM0800X
Mental Health Counselor
TPMC3198
FL
101YP2500X
Professional Counselor
701011944
VA
101YP2500X
Professional Counselor
CTB-2022-0724
NM
101YP2500X
Professional Counselor
LPC.0019066
CO
101YP2500X
Professional Counselor
TLC435PC
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100264520
—
IN
Enumeration date
08/19/2008
Last updated
05/08/2023
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