Provider Demographics
NPI:1730880014
Name:SAWYER, STEPHANY (CBS)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:
Last Name:SAWYER
Suffix:
Gender:F
Credentials:CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10775 MCKINLEY HWY STE C
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46561-9164
Mailing Address - Country:US
Mailing Address - Phone:574-315-3196
Mailing Address - Fax:
Practice Address - Street 1:10775 MCKINLEY HWY STE C
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-9164
Practice Address - Country:US
Practice Address - Phone:574-315-3196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INE5D4432BEA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor