MEDICARE: THOMAS L STEVENS, INC

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	101YP2500X	Professional Counselor	13767	TX

General Provider Information

NPI Number	:	1538581574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS L STEVENS, INC

Provider Business Mailing Address
First Line	:	12620 FM 1960 RD W # A4247
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-5364
Country	:	US
Telephone Number	:	281-493-4499
Fax Number	:

Provider Business Practice Location Address
First Line	:	12337 JONES RD STE 232
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-4844
Country	:	US
Telephone Number	:	281-493-4499
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	THOMAS L STEVENS
Credential	:	LPC-S
Telephone Number	:	281-493-4499

Provider Enumeration Date	:	01/10/2014
Last Update Date	:	01/10/2014

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