Provider Demographics
NPI:1124182340
Name:STETZELBERGER, BARBARA JO (LCSW, DTR)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JO
Last Name:STETZELBERGER
Suffix:
Gender:M
Credentials:LCSW, DTR
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2525 WALLINGWOOD DR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6900
Mailing Address - Country:US
Mailing Address - Phone:512-301-0452
Mailing Address - Fax:512-301-0452
Practice Address - Street 1:2525 WALLINGWOOD DR
Practice Address - Street 2:SUITE 700
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6900
Practice Address - Country:US
Practice Address - Phone:512-301-0452
Practice Address - Fax:512-301-0452
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX186951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0065KSOtherBLUE CROSS BLUE SHIELD