Provider Demographics
NPI:1295173581
Name:MCVEA, STEPHANIE DENISE (PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:DENISE
Last Name:MCVEA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 TRANQUIL WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3650
Mailing Address - Country:US
Mailing Address - Phone:214-498-2958
Mailing Address - Fax:
Practice Address - Street 1:1000 G ST STE 1251000G
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-0840
Practice Address - Country:US
Practice Address - Phone:214-923-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14783101YP2500X
TX67725101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX296285401Medicaid