Provider Demographics
NPI:1477323731
Name:STEPHENS, JAMES GREGORY (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GREGORY
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2512 BOBWHITE DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-2242
Mailing Address - Country:US
Mailing Address - Phone:432-741-3526
Mailing Address - Fax:
Practice Address - Street 1:601 N MARIENFELD ST STE 409
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-4374
Practice Address - Country:US
Practice Address - Phone:432-741-3526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health