Healthcare Provider Details

I. General information

NPI: 1811937063
Provider Name (Legal Business Name): AMY M. STEVENS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 ROSWELL ST NE SUITE 344
MARIETTA GA
30060-3507
US

IV. Provider business mailing address

PO BOX 672853
MARIETTA GA
30006-0048
US

V. Phone/Fax

Practice location:
  • Phone: 770-509-1034
  • Fax:
Mailing address:
  • Phone: 770-509-1034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC004201
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number697269.
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: