Provider Demographics
NPI:1548648678
Name:STEVENS, EMILY (LMHC, LPC, NCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LMHC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2088
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34991
Mailing Address - Country:US
Mailing Address - Phone:404-840-0426
Mailing Address - Fax:
Practice Address - Street 1:509 SE CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3992
Practice Address - Country:US
Practice Address - Phone:404-840-0426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11187101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional