Provider Demographics
NPI:1962595066
Name:BAIN, STEVE FRANK (DMIN, LPC)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:FRANK
Last Name:BAIN
Suffix:
Gender:M
Credentials:DMIN, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5918 BISHOPS MILL DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2417
Mailing Address - Country:US
Mailing Address - Phone:361-813-6981
Mailing Address - Fax:361-334-9723
Practice Address - Street 1:4420 S STAPLES ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2602
Practice Address - Country:US
Practice Address - Phone:361-813-6981
Practice Address - Fax:361-334-9723
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17059101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10013846OtherAMERIGROUP
TX7053LCOtherBLUE CROSS/BLUE SHIELD