Provider Demographics
NPI:1164248225
Name:STEPHENS, LAURINDA MARGARET
Entity type:Individual
Prefix:MRS
First Name:LAURINDA
Middle Name:MARGARET
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LAURINDA
Other - Middle Name:MARGARET
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7058 E IL ROUTE 72 LOT 5
Mailing Address - Street 2:
Mailing Address - City:STILLMAN VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61084-9620
Mailing Address - Country:US
Mailing Address - Phone:608-289-3045
Mailing Address - Fax:
Practice Address - Street 1:332 S MICHIGAN AVE STE 900
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604-4393
Practice Address - Country:US
Practice Address - Phone:217-491-8403
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician