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General NPI Number Information
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NPI Number | 1205145679
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Entity Type | Individual
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Provider Name | DAVID R. R. STEPHENS M.A., LPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 10/01/2010
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 300 CLINTON AVENUE WEST SUITE 21
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5590
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Country | US
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Telephone | 256-945-7959
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Fax |
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Provider Business Mailing Address
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Address Line | 300 CLINTON AVE W SUITE 21
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5527
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Country | US
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Telephone | 256-945-7959
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2776
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License Number State | AL
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