Provider Demographics
NPI:1750053807
Name:BLANCARTE, STEPHANIE (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BLANCARTE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E TWOHIG AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6433
Mailing Address - Country:US
Mailing Address - Phone:325-944-2561
Mailing Address - Fax:325-939-2019
Practice Address - Street 1:906 E 11TH ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3968
Practice Address - Country:US
Practice Address - Phone:830-256-8255
Practice Address - Fax:325-939-2019
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1058821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical