Provider Demographics
NPI:1881028678
Name:STEVENSON, PATRICIA (PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COLUMBIA AVENUE
Mailing Address - Street 2:CHAPIN HIGH SCHOOL
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29063
Mailing Address - Country:US
Mailing Address - Phone:803-575-5529
Mailing Address - Fax:
Practice Address - Street 1:300 COLUMBIA AVE
Practice Address - Street 2:CHAPIN HIGH SCHOOL
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-9422
Practice Address - Country:US
Practice Address - Phone:803-575-5529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist