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NPI Code Detail

MEDICARE: CARL L STEPHENS LCPC

MEDICARE:   CARL L STEPHENS  LCPC
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
1101YM0800XMental Health CounselorLC2159MD

General Provider Information

NPI Number : 1265551329
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARL L STEPHENS LCPC
Provider Business Mailing Address
First Line : 17 DEERWOODS CT
Second Line :
City : MYERSVILLE
State : MD
Zip : 21773
Country : US
Telephone Number : 301-293-1300
Fax Number : 301-293-1911
Provider Business Practice Location Address
First Line : 17 DEERWOODS CT
Second Line :
City : MYERSVILLE
State : MD
Zip : 21773-8432
Country : US
Telephone Number : 301-293-1300
Fax Number : 301-293-1911
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 02/01/2008

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