Provider Demographics
NPI:1801400973
Name:STEPHENS, CLAUDIA LEE (LCSW; PSC;)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:LEE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LCSW; PSC;
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 CHARLOTTSVILLE DR
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-2104
Mailing Address - Country:US
Mailing Address - Phone:972-965-2367
Mailing Address - Fax:
Practice Address - Street 1:1700 CHARLOTTSVILLE DR
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-2104
Practice Address - Country:US
Practice Address - Phone:972-965-2367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX177411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty