Provider Demographics
NPI:1679312318
Name:SHEEN, STEFANI
Entity type:Individual
Prefix:
First Name:STEFANI
Middle Name:
Last Name:SHEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4918 115TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-7484
Mailing Address - Country:US
Mailing Address - Phone:432-853-6254
Mailing Address - Fax:
Practice Address - Street 1:3223 S LOOP 289 STE 320
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1367
Practice Address - Country:US
Practice Address - Phone:806-705-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional