Provider Demographics
NPI:1861664906
Name:STEPHENSEN, DAVID NEIL (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:NEIL
Last Name:STEPHENSEN
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 N LINDSAY RD UNIT 29
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-1520
Mailing Address - Country:US
Mailing Address - Phone:480-296-3095
Mailing Address - Fax:602-222-6534
Practice Address - Street 1:650 E INDIAN SCHOOL RD
Practice Address - Street 2:MAIL CODE 116A9
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1839
Practice Address - Country:US
Practice Address - Phone:480-296-3095
Practice Address - Fax:602-222-6534
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW 112931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical