Provider Demographics
NPI:1831901347
Name:STEPHAN, MICHELLE LYNN (LPC-A)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:STEPHAN
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 FM 306
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4683
Mailing Address - Country:US
Mailing Address - Phone:281-925-7780
Mailing Address - Fax:
Practice Address - Street 1:1067 FM 306
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4683
Practice Address - Country:US
Practice Address - Phone:281-925-7780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health