MEDICARE: EMILY N STEVENSEN

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	225800000X	Recreation Therapist	4795	NC

General Provider Information

NPI Number	:	1215888706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY N STEVENSEN

Provider Business Mailing Address
First Line	:	9305 SW 94TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33176-2013
Country	:	US
Telephone Number	:	507-380-2016
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 W MAIN ST
Second Line	:
City	:	ALBEMARLE
State	:	NC
Zip	:	28001-4641
Country	:	US
Telephone Number	:	704-780-4552
Fax Number	:

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

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ EMILY N STEVENSEN ” Practice Location

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