Provider Demographics
NPI:1548508401
Name:STEVENSON, MATTHEW FLETCHER (MA)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:FLETCHER
Last Name:STEVENSON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19551 W SIMMONS RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-9697
Mailing Address - Country:US
Mailing Address - Phone:405-326-2985
Mailing Address - Fax:
Practice Address - Street 1:19551 W SIMMONS RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73025-9697
Practice Address - Country:US
Practice Address - Phone:405-326-2985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-27
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1178106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist