| Doctor Name: | MARY S STEVENS |
| NPI Number: | 1063407906 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 0904002094 |
| Business Practice Address: | 1000 Commercial Ln Wtcsb Suffolk, VA - 234348148 |
| Business Phone Number: | 7579421069 |
| Business Fax Number: | 7579252213 |
| Mailing Address: | 1000 Commercial Ln, Wtcsb SUFFOLK |
| State: | VA |
| Postal Code: | 234348148 |
| Phone Number: | 7579421069 |
| Fax Number: | 7579252213 |
| NPI Enumeration Date: | 09/16/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0904002094 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |