Provider Demographics
NPI:1497635973
Name:GARDNER, STEPHANIE ANNETTE (MA, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANNETTE
Last Name:GARDNER
Suffix:
Gender:F
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 W GREENVINE CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1699
Mailing Address - Country:US
Mailing Address - Phone:832-300-3058
Mailing Address - Fax:
Practice Address - Street 1:719 SAWDUST RD STE 104
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2946
Practice Address - Country:US
Practice Address - Phone:832-300-3058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99984101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional