Healthcare Provider Details

I. General information

NPI: 1356606826
Provider Name (Legal Business Name): ANITA MARIA STEPHENS MS, LPC, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2012
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4332 RHODA DR
BATON ROUGE LA
70816-4136
US

IV. Provider business mailing address

1320 HALL DR
BAKER LA
70714-5304
US

V. Phone/Fax

Practice location:
  • Phone: 225-235-7273
  • Fax: 225-308-4025
Mailing address:
  • Phone: 225-775-0132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1499
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberAN002462
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: