Provider Demographics
NPI:1982364170
Name:STOOPS, CHANTELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHANTELLE
Middle Name:
Last Name:STOOPS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CHANTELLE
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7607 GANDER PARK
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7607 GANDER PARK
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-3233
Practice Address - Country:US
Practice Address - Phone:210-334-1204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX615001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical