Provider Demographics
NPI:1750192423
Name:STUTES, ERIC (LCDC)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:STUTES
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 IH 35 N FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666
Mailing Address - Country:US
Mailing Address - Phone:832-444-4492
Mailing Address - Fax:
Practice Address - Street 1:1106 IH 35 N FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666
Practice Address - Country:US
Practice Address - Phone:832-444-4492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16708101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)