Provider Demographics
NPI:1073048542
Name:STEVENS, EMILY K (BSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:STEVENS
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 NORTH MAIN ST.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721
Mailing Address - Country:US
Mailing Address - Phone:231-597-9235
Mailing Address - Fax:
Practice Address - Street 1:520 NORTH MAIN ST.
Practice Address - Street 2:SUITE 202
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721
Practice Address - Country:US
Practice Address - Phone:231-597-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)