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General NPI Number Information
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NPI Number | 1114096781
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Entity Type | Individual
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Provider Name | JOHN R STEVENS M.S.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 03/12/2021
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Provider Practice Location Address
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Address Line | 2647 CARNEGIE RD
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City | YORK
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State | PA
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Zip | 17402-3786
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Country | US
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Telephone | 717-755-0921
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Fax |
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Provider Business Mailing Address
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Address Line | 2870 CAROL RD
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City | YORK
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State | PA
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Zip | 17402-3865
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Country | US
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Telephone | 717-755-0921
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Fax | 717-751-0783
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS004861L
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License Number State | PA
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