Provider Demographics
NPI:1255356929
Name:STEIN, TZIVIA E (LCSW)
Entity type:Individual
Prefix:MS
First Name:TZIVIA
Middle Name:E
Last Name:STEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4013 HILLSDALE LANE
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042
Mailing Address - Country:US
Mailing Address - Phone:214-232-5159
Mailing Address - Fax:972-276-2592
Practice Address - Street 1:629 W CENTERVILLE RD
Practice Address - Street 2:SUITE 212
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5460
Practice Address - Country:US
Practice Address - Phone:214-232-5159
Practice Address - Fax:972-276-2592
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX189321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1273609Medicaid
TX11553615OtherCAQH
TX11553615OtherCAQH