Provider Demographics
NPI:1043471352
Name:SPERANZA, STEVEN SAMUEL (LCSW LMSW ACP)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:SAMUEL
Last Name:SPERANZA
Suffix:
Gender:M
Credentials:LCSW LMSW ACP
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 340015
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78734
Mailing Address - Country:US
Mailing Address - Phone:512-909-6624
Mailing Address - Fax:
Practice Address - Street 1:4006 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78734
Practice Address - Country:US
Practice Address - Phone:512-909-6624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13681104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000069CTOtherBLUE CROSS BLUE SHIELD
TX063862901Medicaid
000000225EMedicare PIN
000000225EMedicare Oscar/Certification