Provider Demographics
NPI:1679566541
Name:STEVENS, STEPHANIE ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ANN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6723 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-1409
Mailing Address - Country:US
Mailing Address - Phone:832-746-7529
Mailing Address - Fax:281-540-0272
Practice Address - Street 1:6723 MAPLE DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-1409
Practice Address - Country:US
Practice Address - Phone:832-746-7529
Practice Address - Fax:281-540-0272
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14694101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095952001Medicaid