Provider Demographics
NPI:1720375686
Name:STEPHANIE DODOO COUNSELING & CONSULTING LLC
Entity Type:Organization
Organization Name:STEPHANIE DODOO COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DODOO
Authorized Official - Suffix:
Authorized Official - Credentials:MA LCSW
Authorized Official - Phone:512-374-1803
Mailing Address - Street 1:PO BOX 142275
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78714-2275
Mailing Address - Country:US
Mailing Address - Phone:512-374-1803
Mailing Address - Fax:
Practice Address - Street 1:3810 MEDICAL PKWY
Practice Address - Street 2:SUITE 232
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4026
Practice Address - Country:US
Practice Address - Phone:512-374-1803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX530481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty