Provider Demographics
NPI:1326230640
Name:STEVENSON, LEYANA OVERSTREET (LCSW, CSAC, CSOTP)
Entity Type:Individual
Prefix:
First Name:LEYANA
Middle Name:OVERSTREET
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:LCSW, CSAC, CSOTP
Other - Prefix:
Other - First Name:LEYANA
Other - Middle Name:OVERSTREET
Other - Last Name:STEVENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW MAC CSAC CSOTP
Mailing Address - Street 1:1100 AVALON SQ APT 1350
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-3372
Mailing Address - Country:US
Mailing Address - Phone:757-581-3755
Mailing Address - Fax:
Practice Address - Street 1:423 E 23RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5011
Practice Address - Country:US
Practice Address - Phone:212-686-7500
Practice Address - Fax:212-742-9593
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710102115101YA0400X
VA09040069541041C0700X
VA0812000532101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor