Provider Demographics
NPI:1083786081
Name:STEVENS, TERRY ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:ANN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 E GOLDFINCH GATE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4511
Mailing Address - Country:US
Mailing Address - Phone:602-320-5929
Mailing Address - Fax:480-759-1578
Practice Address - Street 1:3910 E GOLDFINCH GATE LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4511
Practice Address - Country:US
Practice Address - Phone:602-320-5929
Practice Address - Fax:480-759-1578
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health