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General NPI Number Information
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NPI Number | 1053720193
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Entity Type | Individual
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Provider Name | DANIEL THOMAS STEPHENS MA, LMHC, LPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 08/02/2014
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 14050 N 83RD AVE STE 290
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City | PEORIA
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State | AZ
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Zip | 85381-5650
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Country | US
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Telephone | 623-267-5849
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Fax |
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Provider Business Mailing Address
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Address Line | 5411 NE 107TH AVE STE 100
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City | VANCOUVER
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State | WA
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Zip | 98662-6347
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Country | US
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Telephone | 360-609-8535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MC60636677
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License Number State | WA
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