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General NPI Number Information
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NPI Number | 1629292677
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Entity Type | Individual
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Provider Name | VICTORIA STEVENS MA
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 21 GEORGE ST FL 1
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City | LOWELL
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State | MA
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Zip | 01852-2228
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Country | US
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Telephone | 978-453-5736
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Fax | 978-970-5595
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Provider Business Mailing Address
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Address Line | 148 CRICKETBROOK
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City | DOVER
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State | NH
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Zip | 03820-3869
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC6592
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License Number State | MA
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