Provider Demographics
NPI:1639057052
Name:WHITE, STEPHANIE LEIGH (MED, LPCC, NCC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEIGH
Last Name:WHITE
Suffix:
Gender:F
Credentials:MED, LPCC, NCC
Other - Prefix:
Other - First Name:STEVIE
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, LPCC, NCC
Mailing Address - Street 1:1401 AIRPORT PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-1542
Mailing Address - Country:US
Mailing Address - Phone:307-632-7771
Mailing Address - Fax:
Practice Address - Street 1:1635 FOXTRAIL DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9086
Practice Address - Country:US
Practice Address - Phone:970-776-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health