Sally Stader, PH.D.

Psychologist · Lakeland, FL

Individual Active NPI

NPI number 1639397169

Practice location

4404 S.Florida Ave.
Suite #3
Lakeland, FL 33813-2169
Phone
(863) 247-2626

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NPI record

NPI
1639397169
Entity type
Individual (Type 1)
Enumeration date
April 22, 2007
Last updated
December 10, 2022
Certified
December 10, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Psychologist Primary 103T00000X PY5379 FL
Psychologist 103T00000X 20040657A IN

Mailing address

4404 S Florida Ave Ste 3
Lakeland, FL 33813-2183
Phone
(863) 247-2626

About Dr. Stader

Sally Stader, PH.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Psychologist (code 103T00000X). The practice location is 4404 S.Florida Ave., Suite #3, Lakeland, FL 33813-2169. The NPI number 1639397169 was assigned on April 22, 2007 and the record was last updated on December 10, 2022.

Dr. Stader lists 2 licenses in the registry: #PY5379 (FL) for Psychologist; #20040657A (IN) for Psychologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Sally Stader, PH.D.?

The NPI number is 1639397169.

What is the phone number of Dr. Stader?

The phone number listed for the practice location is (863) 247-2626.

Where is Dr. Stader located?

4404 S.Florida Ave., Suite #3, Lakeland, FL 33813-2169.

What is the taxonomy code for Dr. Stader?

The primary taxonomy code is 103T00000X – Psychologist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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