Healthcare Provider Details

I. General information

NPI: 1881920031
Provider Name (Legal Business Name): XUAN STEVENS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2009
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 BUSINESS CENTER DR STE A
ORMOND BEACH FL
32174-6631
US

IV. Provider business mailing address

PO BOX 730434
ORMOND BEACH FL
32173-0434
US

V. Phone/Fax

Practice location:
  • Phone: 386-243-5228
  • Fax: 877-601-7246
Mailing address:
  • Phone: 386-243-5228
  • Fax: 877-601-7246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY7888
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY7888
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY 7888
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: