Provider Demographics
NPI:1841025376
Name:STEPHENS, STACEY (MED, LPC)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S WATTERS RD STE 287
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5232
Mailing Address - Country:US
Mailing Address - Phone:940-373-1707
Mailing Address - Fax:
Practice Address - Street 1:550 S WATTERS RD STE 287
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5232
Practice Address - Country:US
Practice Address - Phone:940-373-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89764101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional