Provider Demographics
NPI:1174592281
Name:STEPHENS, VERA K (BA, MSW, LISW-S)
Entity type:Individual
Prefix:
First Name:VERA
Middle Name:K
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:BA, MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:OH
Mailing Address - Zip Code:43977-9733
Mailing Address - Country:US
Mailing Address - Phone:740-968-7049
Mailing Address - Fax:
Practice Address - Street 1:436 HIGH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:OH
Practice Address - Zip Code:43977-9733
Practice Address - Country:US
Practice Address - Phone:740-968-7049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI87191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHY555070OtherTHE HEALTH PLAN PIN
OH000000235902OtherANTHEM PIN
OH218930OtherTRICARE/MHN PIN
OH267557000OtherMAGELLAN PIN
OH246001OtherMOUNT CARMEL PIN
OH246001OtherMOUNT CARMEL PIN