Provider Demographics
NPI:1043339161
Name:DAWDY, STEPHANIE ANN (LPC, LSSP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:DAWDY
Suffix:
Gender:F
Credentials:LPC, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 131
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-0131
Mailing Address - Country:US
Mailing Address - Phone:806-654-5454
Mailing Address - Fax:806-655-3425
Practice Address - Street 1:412 15TH ST
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-3839
Practice Address - Country:US
Practice Address - Phone:806-654-5454
Practice Address - Fax:806-655-3425
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14967101YP2500X
TX32131103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool