Provider Demographics
NPI:1629527528
Name:STONE-STEVENS, JAMMIE (MA, LAMFT(TEMPORARY))
Entity Type:Individual
Prefix:
First Name:JAMMIE
Middle Name:
Last Name:STONE-STEVENS
Suffix:
Gender:F
Credentials:MA, LAMFT(TEMPORARY)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 CABEZON BLVD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1576
Mailing Address - Country:US
Mailing Address - Phone:505-717-1155
Mailing Address - Fax:
Practice Address - Street 1:2441 CABEZON BLVD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1576
Practice Address - Country:US
Practice Address - Phone:505-717-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-03
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCAMF0203991101Y00000X
101YM0800X
NMT-CLTL0200271101YP2500X
NMCMF0214781106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional