Provider Demographics
NPI:1548503535
Name:STEVENS COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:STEVENS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-602-1115
Mailing Address - Street 1:4200 PERIMETER CENTER DR
Mailing Address - Street 2:STE 125
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2324
Mailing Address - Country:US
Mailing Address - Phone:405-602-1115
Mailing Address - Fax:
Practice Address - Street 1:4200 PERIMETER CENTER DR
Practice Address - Street 2:STE 125
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2324
Practice Address - Country:US
Practice Address - Phone:405-602-1115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty