Provider Demographics
NPI:1235421173
Name:STEVENSON, DEANNA R (LCPC)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:R
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 JRS LANE
Mailing Address - Street 2:
Mailing Address - City:HOBSON
Mailing Address - State:MT
Mailing Address - Zip Code:59452
Mailing Address - Country:US
Mailing Address - Phone:406-853-8806
Mailing Address - Fax:
Practice Address - Street 1:505 W MAIN ST
Practice Address - Street 2:STE 225
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-5703
Practice Address - Country:US
Practice Address - Phone:406-535-5990
Practice Address - Fax:406-535-4564
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional