Provider Demographics
NPI:1720462609
Name:STEPHANIE MORENO, LPC LLC
Entity Type:Organization
Organization Name:STEPHANIE MORENO, LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CRC, CBIS
Authorized Official - Phone:469-616-4626
Mailing Address - Street 1:7140 PRESTON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3284
Mailing Address - Country:US
Mailing Address - Phone:469-616-4626
Mailing Address - Fax:
Practice Address - Street 1:7140 PRESTON RD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3284
Practice Address - Country:US
Practice Address - Phone:469-616-4626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66524251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health