MRS. STEPHANIE MARIE DEATHERAGE
NPI 1669090346
Social Worker - Clinical in Costa Mesa, CA

Active since July 09, 2020
3505 CADILLAC AVENUE, BUILDING O, SUITE 110, COSTA MESA, CA 92626(949) 290-0114 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 8, 2025, Sep 29, 2024, Dec 27, 2022 and 3 more (6 updates tracked since 2020).

About Mrs. Stephanie Marie Deatherage NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. STEPHANIE MARIE DEATHERAGE (NPI 1669090346) is an individual clinical provider in Costa Mesa, California, licensed in California (LCSW129363) and active in the NPI registry since July 2020.

NPPES Registry Identity

NPI1669090346
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. STEPHANIE MARIE DEATHERAGE
Location Address3505 CADILLAC AVENUE, BUILDING O, SUITE 110Costa Mesa, CA 92626-1429
Mailing Address21881 Ute WayLake Forest, CA 92630-3548 · (949) 290-0114
Sole ProprietorYes
Enumeration DateJuly 9, 2020
Last NPPES UpdateApril 8, 20256 updates tracked since enumeration
NPPES CertifiedApril 8, 2025
NPI 1669090346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in CA · LCSW129363
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3505 CADILLAC AVENUE, Costa Mesa, CA 92626

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stephanie Deatherage's NPI number?

The NPI number for Stephanie Deatherage is 1669090346. It was assigned to this individual provider in the NPPES registry on July 9, 2020.

Where is Stephanie Deatherage located?

Stephanie Deatherage practices at 3505 Cadillac Avenue Building O, Suite 110, Costa Mesa, CA 92626. The listed phone number is (949) 290-0114.

What is Stephanie Deatherage's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Stephanie Deatherage was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.