Carolyn M Stephens, M.A., M.S.W.

Individual provider Active NPI Professional Counselor · Pinehurst, TX

NPI 1710043690 · NPPES record last updated Jul 6, 2023

Key facts

NPI
1710043690
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
5909 (TX)
Practice address
37702 Edgewater Dr
Pinehurst, TX 77362-1918
Phone
(281) 333-3393
Fax
(281) 333-0402
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5909TXMDProfessional Counselor
12471TXMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12471 TX
Professional Counselor 101YP2500X 5909 TX Yes

Addresses

Primary practice location

37702 Edgewater Dr
Pinehurst, TX 77362-1918

Mailing address

PO Box 955
Pinehurst, TX 77362-0955
Phone (281) 333-3933

Other identifiers

IdentifierTypeStateIssuer
095503101MedicaidTX

Other providers in Pinehurst, TX

All providers in Pinehurst, TX · Professional Counselor in Texas

Sources for this page

Verify at the official NPI Registry.