Provider Demographics
NPI:1023552072
Name:STEVERSON, PAMELA S (MA, LPC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:S
Last Name:STEVERSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4114 LAKESHORE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4474
Mailing Address - Country:US
Mailing Address - Phone:713-305-8261
Mailing Address - Fax:
Practice Address - Street 1:4501 CARTWRIGHT RD STE 705
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3541
Practice Address - Country:US
Practice Address - Phone:281-969-7124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-10
Last Update Date:2016-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16624101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional