Healthcare Provider Details

I. General information

NPI: 1962513390
Provider Name (Legal Business Name): STEPHEN C SHOMION LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 HORIZON HILL BLVD
SAN ANTONIO TX
78229-2258
US

IV. Provider business mailing address

9223 OXTED
SAN ANTONIO TX
78254-2071
US

V. Phone/Fax

Practice location:
  • Phone: 210-321-2717
  • Fax: 210-321-2728
Mailing address:
  • Phone: 210-681-2197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number08508
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: