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General NPI Number Information
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NPI Number | 1235434507
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Entity Type | Individual
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Provider Name | STEPHANIE KIM ALLEN MSW, LICSW, GMHS
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Gender | Female
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 3301 N 3RD ST
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City | ABILENE
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State | TX
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Zip | 79603-7054
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Country | US
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Telephone | 325-725-0162
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Fax | 855-270-4606
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Provider Business Mailing Address
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Address Line | PO BOX 4113
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City | ABILENE
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State | TX
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Zip | 79608
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Country | US
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Telephone | 325-725-0162
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Fax | 855-270-4606
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW60417321
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 103685
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License Number State | TX
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