Provider Demographics
NPI:1659989051
Name:RODENBERG-LEWIS, STEPHANIE JEANETTE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JEANETTE
Last Name:RODENBERG-LEWIS
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 1:503 FM 359 SUITE 130 #114
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406
Mailing Address - Country:US
Mailing Address - Phone:832-922-1787
Mailing Address - Fax:
Practice Address - Street 1:930 HOLLY HALL DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-2376
Practice Address - Country:US
Practice Address - Phone:832-922-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80542101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty