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General NPI Number Information
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NPI Number | 1588705396
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Entity Type | Individual
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Provider Name | TERESA KATHLEEN STEVENSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20 MANCHESTER RD
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-2412
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Country | US
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Telephone | 845-486-2950
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Fax | 845-486-2999
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Provider Business Mailing Address
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Address Line | 157 BARCLAY RD APT A P.O. BOX 352
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City | CLINTONDALE
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State | NY
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Zip | 12515-5018
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Country | US
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Telephone | 845-883-5403
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 070484-01
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License Number State | NY
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