Provider Demographics
NPI:1689092637
Name:STEVENSON, MONA (LMHC)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 COURT STREET
Mailing Address - Street 2:SUITE 600
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11242
Mailing Address - Country:US
Mailing Address - Phone:718-510-6545
Mailing Address - Fax:
Practice Address - Street 1:26 COURT ST STE 600
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-1106
Practice Address - Country:US
Practice Address - Phone:718-510-6545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005983101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health