MEDICARE: MRS. MELEA CARY STEPHENS 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	101YP2500X	Professional Counselor	2184	AL

General Provider Information

NPI Number	:	1356652747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELEA CARY STEPHENS LPC

Provider Business Mailing Address
First Line	:	3104 BLUE LAKE DR
Second Line	:	SUITE 100
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2345
Country	:	US
Telephone Number	:	205-977-3003
Fax Number	:	205-977-3939

Provider Business Practice Location Address
First Line	:	3104 BLUE LAKE DR
Second Line	:	SUITE 100
City	:	VESTAVIA
State	:	AL
Zip	:	35243-2345
Country	:	US
Telephone Number	:	205-977-3003
Fax Number	:	205-977-3939

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

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	06/30/2010

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