Provider Demographics
NPI:1649669144
Name:GREENBERG, STEPHANIE H (MS, LPC, LCDC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:H
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6234 ROYALTON DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3446
Mailing Address - Country:US
Mailing Address - Phone:214-766-1542
Mailing Address - Fax:
Practice Address - Street 1:1221 ABRAMS RD STE 326
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5574
Practice Address - Country:US
Practice Address - Phone:469-708-7614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73609101Y00000X, 101YM0800X, 101YP2500X
TX13234101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health