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General NPI Number Information
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NPI Number | 1407007354
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Entity Type | Organization
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Legal Business Name | JOANNE M. STEVENS, LCSW,LLC
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 2 TUNXIS RD STE 207
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City | TARIFFVILLE
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State | CT
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Zip | 06081-9686
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Country | US
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Telephone | 860-798-5530
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Fax | 860-844-0463
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Provider Business Mailing Address
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Address Line | 91 BARNDOOR HILLS RD
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City | GRANBY
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State | CT
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Zip | 06035-2916
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Country | US
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Telephone | 860-798-5530
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Fax | 860-844-0463
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Authorized Official
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Title or Position | OWNER
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Name | JOANNE M. STEVENS
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Credential | LCSW
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Telephone | 860-798-5530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 005728
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License Number State | CT
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