Provider Demographics
NPI:1457326290
Name:STEVENS, DON EUGENE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:EUGENE
Last Name:STEVENS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11981 NE WOODRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-8606
Mailing Address - Country:US
Mailing Address - Phone:816-632-2003
Mailing Address - Fax:
Practice Address - Street 1:508 NORTHLAND DR
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-1348
Practice Address - Country:US
Practice Address - Phone:816-632-2970
Practice Address - Fax:816-632-7999
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0010341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0002412Medicare ID - Type Unspecified