Provider Demographics
NPI:1558419895
Name:STEIN, NINA (LPC)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4136
Mailing Address - Country:US
Mailing Address - Phone:806-356-0404
Mailing Address - Fax:806-356-0590
Practice Address - Street 1:12 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4136
Practice Address - Country:US
Practice Address - Phone:806-356-0404
Practice Address - Fax:806-356-0590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10779101YM0800X
TX4137106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203085OtherVALUEOPTIONS
TX0238193OtherCIGNA HEALTH
TX2235578OtherCIGNA BEHAVIORAL
TX7421116OtherAETNA
TX2806LCOtherBCBS
TX0579889000OtherMAGELLAN