Provider Demographics
NPI:1467625467
Name:STEPHENS, ANGELIA (MED, LPC, CEAP)
Entity Type:Individual
Prefix:MS
First Name:ANGELIA
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MED, LPC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 ROSE HILL CT
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-2054
Mailing Address - Country:US
Mailing Address - Phone:713-628-9952
Mailing Address - Fax:
Practice Address - Street 1:2225 COUNTY ROAD 90
Practice Address - Street 2:SUITE 221
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4890
Practice Address - Country:US
Practice Address - Phone:713-628-9952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19358101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional