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General NPI Number Information
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NPI Number | 1346575107
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Entity Type | Individual
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Provider Name | AMY STEVENSON LCPC,LADC,CCS, LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 05/19/2017
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Provider Practice Location Address
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Address Line | 4010 SAWYER RD
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City | SARASOTA
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State | FL
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Zip | 34233-1272
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Country | US
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Telephone | 941-782-4150
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Fax | 941-782-4898
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Provider Business Mailing Address
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Address Line | P.O. BOX 9478
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City | BRADENTON
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State | FL
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Zip | 34206
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Country | US
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Telephone | 941-782-4299
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Fax | 941-782-4301
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CC2411
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CCS3580
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH14923
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License Number State | FL
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