Provider Demographics
NPI:1073807723
Name:LEGENDRE, STEPHANIE (MA, LPC-S, RPT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:LEGENDRE
Suffix:
Gender:F
Credentials:MA, LPC-S, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SOUTH FRY ROAD SUITE 465
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450
Mailing Address - Country:US
Mailing Address - Phone:281-940-8515
Mailing Address - Fax:888-972-1582
Practice Address - Street 1:707 S FRY RD STE 465
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2259
Practice Address - Country:US
Practice Address - Phone:281-940-8515
Practice Address - Fax:888-972-1582
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-30
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67874101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional