MEDICARE: KENNETH STEVENS

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	CW013624	PA

General Provider Information

NPI Number	:	1902753254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH STEVENS

Provider Business Mailing Address
First Line	:	3084 S GIOVANNA DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85730-3106
Country	:	US
Telephone Number	:	520-808-7037
Fax Number	:

Provider Business Practice Location Address
First Line	:	3084 S GIOVANNA DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85730-3106
Country	:	US
Telephone Number	:	520-808-7037
Fax Number	:

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

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “ KENNETH STEVENS ” Practice Location

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