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NPI Code Detail

MEDICARE: SHANIAH MARIE STEPHENS

MEDICARE: SHANIAH MARIE STEPHENS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1790618841
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANIAH MARIE STEPHENS
Provider Business Mailing Address
First Line : 8628 OVERHILL DR
Second Line :
City : MANASSAS PARK
State : VA
Zip : 20111-2313
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3930 PENDER DR STE 350
Second Line :
City : FAIRFAX
State : VA
Zip : 22030-0989
Country : US
Telephone Number : 703-865-8686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ SHANIAH MARIE STEPHENS ” Practice Location

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