Provider Demographics
NPI:1962966978
Name:STEEN, JESSE HARLEY (LPC-INTERN)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:HARLEY
Last Name:STEEN
Suffix:
Gender:M
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7503 GLENHILL RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-2011
Mailing Address - Country:US
Mailing Address - Phone:512-971-6053
Mailing Address - Fax:
Practice Address - Street 1:601 W 18TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1111
Practice Address - Country:US
Practice Address - Phone:512-766-6866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79480101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty