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NPI Code Detail

MEDICARE: DR. MICHAEL JACK STEDHAM LPC LMFT

MEDICARE: DR. MICHAEL JACK STEDHAM LPC LMFT
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
1101YP2500XProfessional Counselor6184TX
2106H00000XMarriage & Family Therapist2283TX

Other Identifiers

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

General Provider Information

NPI Number : 1346312626
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JACK STEDHAM LPC LMFT
Provider Business Mailing Address
First Line : 301 S CENTER ST
Second Line : SUITE 214
City : ARLINGTON
State : TX
Zip : 76010-7139
Country : US
Telephone Number : 817-276-6412
Fax Number : 817-276-6438
Provider Business Practice Location Address
First Line : 301 S CENTER ST
Second Line : SUITE 214
City : ARLINGTON
State : TX
Zip : 76010-7139
Country : US
Telephone Number : 817-276-6412
Fax Number : 817-276-6438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 09/11/2025

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