Provider Demographics
NPI:1215228689
Name:STEVENSON, ALINA (PSYD)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ALINA
Other - Middle Name:
Other - Last Name:STEVENSON PSYD PLLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:633 HENLEY ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-5605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:640 N OLD WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3881
Practice Address - Country:US
Practice Address - Phone:248-804-2199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014623103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical