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General NPI Number Information
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NPI Number | 1861664906
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Entity Type | Individual
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Provider Name | DAVID NEIL STEPHENSEN MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 650 E INDIAN SCHOOL RD MAIL CODE 116A9
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City | PHOENIX
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State | AZ
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Zip | 85012-1839
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Country | US
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Telephone | 480-296-3095
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Fax | 602-222-6534
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Provider Business Mailing Address
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Address Line | 2560 N LINDSAY RD UNIT 29
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City | MESA
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State | AZ
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Zip | 85213-1520
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Country | US
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Telephone | 480-296-3095
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Fax | 602-222-6534
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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 | LCSW 11293
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License Number State | AZ
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