Provider Demographics
NPI:1013573989
Name:STEVENS, DION (PEER SUPPORT)
Entity Type:Individual
Prefix:MR
First Name:DION
Middle Name:
Last Name:STEVENS
Suffix:
Gender:M
Credentials:PEER SUPPORT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4867 URBANA RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502
Mailing Address - Country:US
Mailing Address - Phone:937-717-5843
Mailing Address - Fax:937-717-5995
Practice Address - Street 1:4867 URBANA RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502
Practice Address - Country:US
Practice Address - Phone:937-717-5843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist