Provider Demographics
NPI:1740564301
Name:STEVENS, PATRICIA (BHP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:BHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 PALMER ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1300
Mailing Address - Country:US
Mailing Address - Phone:207-454-0270
Mailing Address - Fax:207-454-0232
Practice Address - Street 1:127 PALMER ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1300
Practice Address - Country:US
Practice Address - Phone:207-454-0270
Practice Address - Fax:207-454-0232
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME103850000Medicaid