Provider Demographics
NPI:1093550253
Name:STEPHEN, JOEL ALAN (LMSW)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:ALAN
Last Name:STEPHEN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 AVIGNON DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5331
Mailing Address - Country:US
Mailing Address - Phone:737-333-1656
Mailing Address - Fax:
Practice Address - Street 1:1701 TOOMEY RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-1033
Practice Address - Country:US
Practice Address - Phone:737-333-1656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1122921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical