Provider Demographics
NPI:1710182134
Name:SONLIGHT PSYCHOLOGICAL SERVICES, PC
Entity Type:Organization
Organization Name:SONLIGHT PSYCHOLOGICAL SERVICES, PC
Other - Org Name:ALAN D STEPHENSON, PHD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEPHENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-803-5294
Mailing Address - Street 1:326 S RAVINIA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-5182
Mailing Address - Country:US
Mailing Address - Phone:214-549-5442
Mailing Address - Fax:214-339-2279
Practice Address - Street 1:326 S RAVINIA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-5182
Practice Address - Country:US
Practice Address - Phone:214-549-5442
Practice Address - Fax:214-339-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-16
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24586103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173170501Medicaid