MEDICARE: AMANDA JO STEVENS LMFT

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	106H00000X	Marriage & Family Therapist	35002322A	IN

General Provider Information

NPI Number	:	1437097581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA JO STEVENS LMFT

Provider Business Mailing Address
First Line	:	9247 N MERIDIAN ST STE 275
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1879
Country	:	US
Telephone Number	:	201-252-7547
Fax Number	:

Provider Business Practice Location Address
First Line	:	9247 N MERIDIAN ST STE 275
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1879
Country	:	US
Telephone Number	:	201-252-7547
Fax Number	:

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

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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