Healthcare Provider Details

I. General information

NPI: 1073048542
Provider Name (Legal Business Name): EMILY K STEVENS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6250 M 66 N
CHARLEVOIX MI
49720-9272
US

IV. Provider business mailing address

1420 PLAZA DR
PETOSKEY MI
49770-9420
US

V. Phone/Fax

Practice location:
  • Phone: 231-547-5885
  • Fax:
Mailing address:
  • Phone: 231-547-5885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801115081
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: