MEDICARE: MR. STEPHEN MICHAEL STEPANOVICH M.S. MFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	2688	NV

General Provider Information

NPI Number	:	1518228956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN MICHAEL STEPANOVICH M.S. MFT

Provider Business Mailing Address
First Line	:	3175 E WARM SPRINGS RD STE 111
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3137
Country	:	US
Telephone Number	:	702-743-4497
Fax Number	:

Provider Business Practice Location Address
First Line	:	3175 E WARM SPRINGS RD STE 111
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3137
Country	:	US
Telephone Number	:	702-743-4497
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2012
Last Update Date	:	11/07/2024

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