MEDICARE: MS. GWENDOLYN FAYE STEPHENS LCSW

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	1041C0700X	Clinical Social Worker	57596	TX
2	1041C0700X	Clinical Social Worker	C6498	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285648733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GWENDOLYN FAYE STEPHENS LCSW

Provider Business Mailing Address
First Line	:	PO BOX 38
Second Line	:
City	:	DAYTON
State	:	TX
Zip	:	77535-0001
Country	:	US
Telephone Number	:	281-783-8182
Fax Number	:	281-899-5295

Provider Business Practice Location Address
First Line	:	4719 ATASCOCITA RD
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-2854
Country	:	US
Telephone Number	:	936-262-7800
Fax Number	:	281-899-5295

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	05/08/2026

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