Provider Demographics
NPI:1558432799
Name:VISOKAY, STEPHANIE WOODRUFF (LPC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:WOODRUFF
Last Name:VISOKAY
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 1:3014 REGATA RUN DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-7425
Mailing Address - Country:US
Mailing Address - Phone:281-648-1063
Mailing Address - Fax:281-648-1067
Practice Address - Street 1:122 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2400
Practice Address - Country:US
Practice Address - Phone:281-554-4005
Practice Address - Fax:281-648-1067
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
175193532185OtherHUMANA
2903LCOtherBCBS
1125090OtherCIGNA
38993OtherHORIZON HEALTH
468358OtherVALUE OPTIONS
7887433OtherAETNA