Provider Demographics
NPI:1306834767
Name:STEPHENSON, JAMES (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 45 BOX 777
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09468
Mailing Address - Country:US
Mailing Address - Phone:44176-560-9804
Mailing Address - Fax:
Practice Address - Street 1:UNIT 5210 BOX 230
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09461
Practice Address - Country:US
Practice Address - Phone:44142-377-7409
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL912103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical