MEDICARE: MS. TERRY ANN STEVENS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LPC-0091	AZ

General Provider Information

NPI Number	:	1083786081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERRY ANN STEVENS LPC

Provider Business Mailing Address
First Line	:	3910 E GOLDFINCH GATE LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-4511
Country	:	US
Telephone Number	:	602-320-5929
Fax Number	:	480-759-1578

Provider Business Practice Location Address
First Line	:	3910 E GOLDFINCH GATE LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-4511
Country	:	US
Telephone Number	:	602-320-5929
Fax Number	:	480-759-1578

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/08/2007

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