Provider Demographics
NPI:1033760848
Name:ALTHOF-STEPHENS, DANA CHRISTINE (LPC, LCDC, PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:CHRISTINE
Last Name:ALTHOF-STEPHENS
Suffix:
Gender:F
Credentials:LPC, LCDC, PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 N 14TH ST UNIT 277
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-4166
Mailing Address - Country:US
Mailing Address - Phone:832-486-0481
Mailing Address - Fax:
Practice Address - Street 1:519 N SAM HOUSTON PKWY E STE 155
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4061
Practice Address - Country:US
Practice Address - Phone:832-943-4035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX373188702Medicaid