Provider Demographics
NPI:1629729090
Name:HOOTON, STEPHANIE (MA, NCC, LPC-S)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:HOOTON
Suffix:
Gender:F
Credentials:MA, NCC, LPC-S
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:BLETHEN
Other - Last Name:HOOTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, NCC, LPC-S
Mailing Address - Street 1:196 UNITY
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5854
Mailing Address - Country:US
Mailing Address - Phone:512-212-0105
Mailing Address - Fax:
Practice Address - Street 1:196 UNITY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-5854
Practice Address - Country:US
Practice Address - Phone:512-212-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional