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General NPI Number Information
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NPI Number | 1801447453
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Entity Type | Individual
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Provider Name | CHRISTOPHER DWAYNE STEPHENS LGPC, CAC-AD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 181 E MAIN ST STE 4
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City | WESTMINSTER
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State | MD
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Zip | 21157-6195
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Country | US
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Telephone | 717-659-6302
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Fax |
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Provider Business Mailing Address
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Address Line | 149 GRAND DR
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City | TANEYTOWN
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State | MD
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Zip | 21787-2408
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Country | US
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Telephone | 717-659-6302
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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 | LGP9749
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC11562
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License Number State | MD
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