Provider Demographics
NPI:1730249194
Name:STEVENS, JOHN H JR (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:STEVENS
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 HORSE POND RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-2703
Mailing Address - Country:US
Mailing Address - Phone:978-443-7960
Mailing Address - Fax:
Practice Address - Street 1:168 HORSE POND RD
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-2703
Practice Address - Country:US
Practice Address - Phone:978-443-7960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3981103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist