MEDICARE: MICHELLE C STEVENS

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	100.0134433	VT
2	106H00000X	Marriage & Family Therapist	115286	CA
3	106H00000X	Marriage & Family Therapist	MF7716	ME
4	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1922488600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE C STEVENS

Provider Business Mailing Address
First Line	:	PO BOX 592
Second Line	:
City	:	GRAY
State	:	ME
Zip	:	04039-0592
Country	:	US
Telephone Number	:	626-461-9295
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 592
Second Line	:
City	:	GRAY
State	:	ME
Zip	:	04039-0592
Country	:	US
Telephone Number	:	626-461-9295
Fax Number	:

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

Provider Enumeration Date	:	06/08/2015
Last Update Date	:	01/10/2026

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Directions to “ MICHELLE C STEVENS ” Practice Location

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