Healthcare Provider Details

I. General information

NPI: 1316738909
Provider Name (Legal Business Name): JENNIFER STEPHENSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 SHOAL CREEK BLVD STE 202
AUSTIN TX
78757-7591
US

IV. Provider business mailing address

9501 N FM 620 RD APT 23101
AUSTIN TX
78726-2933
US

V. Phone/Fax

Practice location:
  • Phone: 512-201-4501
  • Fax:
Mailing address:
  • Phone: 314-319-2670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number111031
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: