Provider Demographics
NPI:1518228956
Name:STEPANOVICH, STEPHEN MICHAEL (MS MFT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:STEPANOVICH
Suffix:
Gender:M
Credentials:MS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3097 E WARM SPRINGS RD
Mailing Address - Street 2:BUILDING 4, SUITE 400
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3756
Mailing Address - Country:US
Mailing Address - Phone:702-743-4497
Mailing Address - Fax:
Practice Address - Street 1:3097 E WARM SPRINGS RD
Practice Address - Street 2:BUILDING 4, SUITE 400
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3756
Practice Address - Country:US
Practice Address - Phone:702-743-4497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0381106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist