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NPI Code Detail

MEDICARE: MRS. FELICIA MONIQUE STEVENSON BSW, CASAC-T

MEDICARE: MRS. FELICIA MONIQUE STEVENSON BSW, CASAC-T
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
1101YA0400XAddiction (Substance Use Disorder) CounselorNY

General Provider Information

NPI Number : 1326125378
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. FELICIA MONIQUE STEVENSON BSW, CASAC-T
Provider Business Mailing Address
First Line : 425 MICHIGAN AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14203-2209
Country : US
Telephone Number : 716-848-2076
Fax Number : 716-848-2249
Provider Business Practice Location Address
First Line : 425 MICHIGAN AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14203-2209
Country : US
Telephone Number : 716-848-2076
Fax Number : 716-848-2249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/19/2010

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Directions to “ MRS. FELICIA MONIQUE STEVENSON BSW, CASAC-T” Practice Location

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