Provider Demographics
NPI:1689286437
Name:THOMPSON, STEFFANIE (MED, LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:STEFFANIE
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MED, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 OAK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:VAN VLECK
Mailing Address - State:TX
Mailing Address - Zip Code:77482-6325
Mailing Address - Country:US
Mailing Address - Phone:979-557-6100
Mailing Address - Fax:
Practice Address - Street 1:1216 N VELASCO ST STE 105
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-3078
Practice Address - Country:US
Practice Address - Phone:979-476-0993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80621101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty