Provider Demographics
NPI:1497946263
Name:PRAVEL, STEPHEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:PRAVEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3056
Mailing Address - Country:US
Mailing Address - Phone:248-885-8885
Mailing Address - Fax:248-792-9043
Practice Address - Street 1:1935 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3056
Practice Address - Country:US
Practice Address - Phone:248-885-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010115261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical