Provider Demographics
NPI:1346919016
Name:STEPHENS, LINDEN GUS
Entity Type:Individual
Prefix:MR
First Name:LINDEN
Middle Name:GUS
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:LINDEN
Other - Middle Name:GUS
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LINDEN
Mailing Address - Street 1:2000 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4314
Mailing Address - Country:US
Mailing Address - Phone:216-288-4538
Mailing Address - Fax:
Practice Address - Street 1:2000 AUBURN DR
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4314
Practice Address - Country:US
Practice Address - Phone:216-288-4538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health