Provider Demographics
NPI:1881035152
Name:WOODARD, STEPHANIE L (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:WOODARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 LAGO VIENTO LN
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-8595
Mailing Address - Country:US
Mailing Address - Phone:254-715-2741
Mailing Address - Fax:
Practice Address - Street 1:204 LAGO VIENTO LN
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-8595
Practice Address - Country:US
Practice Address - Phone:254-716-2741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68121101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional