Provider Demographics
NPI:1619474640
Name:STEPHENSON, BARBARA JEAN
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9110 RAILROAD DR STE 310A
Mailing Address - Street 2:
Mailing Address - City:MANASSAS PARK
Mailing Address - State:VA
Mailing Address - Zip Code:20111-7042
Mailing Address - Country:US
Mailing Address - Phone:304-617-6788
Mailing Address - Fax:703-334-2206
Practice Address - Street 1:9110 RAILROAD DR STE 310A
Practice Address - Street 2:
Practice Address - City:MANASSAS PARK
Practice Address - State:VA
Practice Address - Zip Code:20111-7042
Practice Address - Country:US
Practice Address - Phone:304-617-6788
Practice Address - Fax:703-334-2206
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001483106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist