Stephanie Michelle Stidham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW64567 Issued in TX

Practice address

3308 Pablo Cir
Round Rock, TX 78665-2160

Phone

(949) 973-7419

NPI assigned

Jun 25, 2020

Last updated

Jun 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Stephanie Michelle Wilgus Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A & B Counseling LLC

  • In Home Supportive Care Agency
  • Fort Lauderdale, FL
  • NPI 1316400203
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1811514821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3308 PABLO CIR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652160",
            "telephone_number": "949-973-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 PABLO CIR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652160",
            "telephone_number": "949-973-7419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STIDHAM",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23247",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "LCSW64567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WILGUS",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Ann Stewart, PHYSICIAN ASSISTANT
• Hannah Claire Elferink Stewart
• Rhema Stewart, M.ED
• Ruth Stewart
• Keren Aviv Stick, PA
• Hayley Noel Stiles, BCBA
• Tiemi Stiles, LPC ASSOCIATE
• Wesley Dean Stobaugh, LCSW
• Jerrad Michael Stoddard, PA
• Andrew A Stoebner, M.D.

• Clinical Social Worker in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.