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1326230640 NPI number — LEYANA OVERSTREET STEVENSON LCSW, CSAC, CSOTP

NPI Number: 1326230640
Health Care Provider/Practitioner: LEYANA OVERSTREET STEVENSON LCSW, CSAC, CSOTP

Information about “1326230640” NPI (LEYANA OVERSTREET STEVENSON LCSW, CSAC, CSOTP) exists in 1326230640 in HTML format HTML  |  1326230640 in plain Text format TXT  |  1326230640 in PDF (Portable Document Format) PDF  |  1326230640 in an XML format XML  formats.

NPI Number : 1326230640 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1326230640",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STEVENSON",
    "FirstName": "LEYANA",
    "MiddleName": "OVERSTREET",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LCSW, CSAC, CSOTP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "STEVENSON",
    "OtherFirstName": "LEYANA",
    "OtherMiddleName": "OVERSTREET",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LCSW MAC CSAC CSOTP",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "1100 AVALON SQ APT 1350",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GLEN COVE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11542-3372",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "757-581-3755",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "423 E 23RD ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10010-5011",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-686-7500",
    "PracticeLocationAddressFaxNumber": "212-742-9593",
    "EnumerationDate": "08/10/2007",
    "LastUpdateDate": "05/18/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YA0400X",
          "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
          "LicenseNumber": "0710102115",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "0904006954",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "0812000532",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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