Provider Demographics
NPI:1386040269
Name:STEVENSON, LIANNE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:LIANNE
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 COURTENAY DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3421
Mailing Address - Country:US
Mailing Address - Phone:404-875-4551
Mailing Address - Fax:
Practice Address - Street 1:690 COURTENAY DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3421
Practice Address - Country:US
Practice Address - Phone:404-875-4551
Practice Address - Fax:404-875-1394
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0028701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical