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General NPI Number Information
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NPI Number | 1063009306
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Entity Type | Individual
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Provider Name | SANTIA SADE STEVENSON LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 1350 SCENIC HWY N SUITE 266
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City | SNELLVILLE
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State | GA
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Zip | 30078
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Country | US
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Telephone | 770-569-3532
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Fax | 770-358-5200
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Provider Business Mailing Address
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Address Line | P.O. BOX 1132
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City | OXFORD.
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State | GA
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Zip | 30054
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Country | US
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Telephone | 678-724-7805
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW007309
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License Number State | GA
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