Provider Demographics
NPI:1851509087
Name:BURCHELL, STEPHANIE (LMFT-A)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:BURCHELL
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 S CANTERBURY CT
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2743
Mailing Address - Country:US
Mailing Address - Phone:214-534-6177
Mailing Address - Fax:
Practice Address - Street 1:3650 W WHEATLAND RD
Practice Address - Street 2:SUITE D
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3494
Practice Address - Country:US
Practice Address - Phone:214-534-6177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201114106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist