Provider Demographics
NPI:1548354418
Name:PIEKARSKI, STEPHANIE A (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:A
Last Name:PIEKARSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:CALPELLA
Mailing Address - State:CA
Mailing Address - Zip Code:95418-0387
Mailing Address - Country:US
Mailing Address - Phone:707-467-5612
Mailing Address - Fax:
Practice Address - Street 1:6991 N STATE ST
Practice Address - Street 2:
Practice Address - City:REDWOOD VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95470-9629
Practice Address - Country:US
Practice Address - Phone:707-467-5612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR39331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR3933OtherOREGON BOARD OF BEHAVIORAL SCIENCES