MEDICARE: MR. BRIAN JOHN STEVENSON MSW

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

General Provider Information

NPI Number	:	1174401921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN JOHN STEVENSON MSW

Provider Business Mailing Address
First Line	:	18311 HIGHWOODS PRESERVE PKWY UNIT 1106
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1794
Country	:	US
Telephone Number	:	201-284-2202
Fax Number	:

Provider Business Practice Location Address
First Line	:	18311 HIGHWOODS PRESERVE PKWY UNIT 1106
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1794
Country	:	US
Telephone Number	:	201-284-2202
Fax Number	:

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

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	08/21/2025

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