Provider Demographics
NPI:1437406808
Name:MARKS, STEPHANIE LINDA (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LINDA
Last Name:MARKS
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20915 KINGSLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5548
Mailing Address - Country:US
Mailing Address - Phone:281-579-0703
Mailing Address - Fax:281-398-9719
Practice Address - Street 1:20915 KINGSLAND BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-5548
Practice Address - Country:US
Practice Address - Phone:281-579-0703
Practice Address - Fax:281-398-9719
Is Sole Proprietor?:No
Enumeration Date:2012-08-05
Last Update Date:2012-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69238101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional