Individual
ELIZABETH A STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W. A.C.P.
Contact information
Practice address
3840 HULEN ST, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76107-7277
(817) 569-4396
(817) 569-4517
Mailing address
PO BOX 2603, HTN, CLIENT ACCOUNTING, FORT WORTH, TX 76113-2603
(817) 569-4396
(817) 569-4517
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19525
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089124402
—
TX
01
—
089124403
MEDICAID CSHCN
TX
01
—
87247Q
BCBS
TX
Enumeration date
02/19/2008
Last updated
03/19/2019
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