Provider Demographics
NPI:1033924154
Name:BUNTING, STEFANIE NICOLE (LMSW)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:NICOLE
Last Name:BUNTING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:NICOLE
Other - Last Name:SEMROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1445 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALEDO
Mailing Address - State:TX
Mailing Address - Zip Code:76008-2894
Mailing Address - Country:US
Mailing Address - Phone:254-366-2035
Mailing Address - Fax:
Practice Address - Street 1:721 RANCH HOUSE RD
Practice Address - Street 2:
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76087-7613
Practice Address - Country:US
Practice Address - Phone:313-314-7325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33334104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker