MEDICARE: SHEALYN ELIZABETH STEPHENS M.S., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	82887	TX

General Provider Information

NPI Number	:	1225788235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEALYN ELIZABETH STEPHENS M.S., LPC

Provider Business Mailing Address
First Line	:	357 HIGHWAY 22
Second Line	:
City	:	CLIFTON
State	:	TX
Zip	:	76634-3358
Country	:	US
Telephone Number	:	940-453-7137
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 AUSTIN AVE
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76701-2117
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:	281-648-2200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2022
Last Update Date	:	05/10/2023

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