Individual
JACQUELINE STEPHANIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMHC
Contact information
Practice address
208 E MAIN ST, MANASQUAN, NJ 08736-3044
(732) 996-9442
Mailing address
208 E MAIN ST, MANASQUAN, NJ 08736-3044
(732) 996-9442
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
003184
NY
101YP2500X
Professional Counselor
Primary
37PC00388700
NJ
Other
Enumeration date
03/23/2009
Last updated
07/26/2010
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