Doctor Name: | CARL L STEPHENS |
NPI Number: | 1265551329 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | LC2159 |
Business Practice Address: | 17 Deerwoods Ct Myersville, MD - 217738432 |
Business Phone Number: | 3012931300 |
Business Fax Number: | 3012931911 |
Mailing Address: | 17 Deerwoods Ct, MYERSVILLE |
State: | MD |
Postal Code: | 21773 |
Phone Number: | 3012931300 |
Fax Number: | 3012931911 |
NPI Enumeration Date: | 03/28/2007 |
NPI Last Update Date: | 02/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LC2159 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |