Provider Demographics
NPI:1730395351
Name:LOMAX, STEPHANIE ELAINE (LCSW-R, CASAC, SAP)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ELAINE
Last Name:LOMAX
Suffix:
Gender:F
Credentials:LCSW-R, CASAC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:164-33 109TH RD.
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433
Mailing Address - Country:US
Mailing Address - Phone:347-683-8928
Mailing Address - Fax:718-276-8056
Practice Address - Street 1:165-38A SUITE#1 BAISLEY BLVD.JAMAICA, NY 11434
Practice Address - Street 2:93 MACDOUGAL ST.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233
Practice Address - Country:US
Practice Address - Phone:347-683-8928
Practice Address - Fax:718-276-8056
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6130101YA0400X
NYR0543491041C0700X
MI68011141481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)