MEDICARE: AYSHA STEPHENSON

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1417420563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYSHA STEPHENSON

Provider Business Mailing Address
First Line	:	26719 SOUTHWESTERN HWY
Second Line	:
City	:	REDFORD
State	:	MI
Zip	:	48239-2222
Country	:	US
Telephone Number	:	313-646-5109
Fax Number	:

Provider Business Practice Location Address
First Line	:	17199 N LAUREL PARK DR
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48152-2683
Country	:	US
Telephone Number	:	800-693-1916
Fax Number	:

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

Provider Enumeration Date	:	01/10/2019
Last Update Date	:	03/20/2026

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Directions to “ AYSHA STEPHENSON ” Practice Location

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