Provider Demographics
NPI:1720523657
Name:STEPHENS, GINGER FRANCES (LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:FRANCES
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-6120
Mailing Address - Country:US
Mailing Address - Phone:936-305-3070
Mailing Address - Fax:936-305-3070
Practice Address - Street 1:1808 SOUTH ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75964-6120
Practice Address - Country:US
Practice Address - Phone:936-305-3070
Practice Address - Fax:363-053-0719
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12716101YA0400X
TX74108101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health