MEDICARE: VICTORIA LEANNE STEVENS LPC-A

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	101YM0800X	Mental Health Counselor	10141	SC

General Provider Information

NPI Number	:	1447060025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA LEANNE STEVENS LPC-A

Provider Business Mailing Address
First Line	:	1500 WIREGRASS WAY
Second Line	:
City	:	HARDEEVILLE
State	:	SC
Zip	:	29927-4288
Country	:	US
Telephone Number	:	785-845-5001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1435 STUART ENGALS BLVD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-7311
Country	:	US
Telephone Number	:	785-845-5001
Fax Number	:

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

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	01/07/2025

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Directions to “ VICTORIA LEANNE STEVENS LPC-A” Practice Location

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