Provider Demographics
NPI:1588307599
Name:TEYEGAGA, STELLA (LPC, NCC)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name:TEYEGAGA
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23410 GRAND RESERVE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-4989
Mailing Address - Country:US
Mailing Address - Phone:281-500-8659
Mailing Address - Fax:
Practice Address - Street 1:23410 GRAND RESERVE DR STE 301
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-4989
Practice Address - Country:US
Practice Address - Phone:281-500-8659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-20332101YM0800X
TX90586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health