Provider Demographics
NPI:1669668679
Name:STEVENS, AMARYLLIIS FRANCES (MSW)
Entity Type:Individual
Prefix:MS
First Name:AMARYLLIIS
Middle Name:FRANCES
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WADSWORTH STREET
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-527-1124
Mailing Address - Fax:860-724-2539
Practice Address - Street 1:45 WADSWORTH STREET
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-527-1124
Practice Address - Fax:860-724-2539
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health