Healthcare Provider Details

I. General information

NPI: 1285648733
Provider Name (Legal Business Name): GWENDOLYN FAYE STEPHENS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GWEN STEPHENS LCSW

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4719 ATASCOCITA RD
HUMBLE TX
77346-2854
US

IV. Provider business mailing address

PO BOX 38
DAYTON TX
77535-0001
US

V. Phone/Fax

Practice location:
  • Phone: 936-262-7800
  • Fax: 281-899-5295
Mailing address:
  • Phone: 281-783-8182
  • Fax: 281-899-5295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number57596
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC6498
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: