Provider Demographics
NPI:1952650814
Name:STEVENS, NATALIE (LCSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:5105 CRITTENDEN AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-1360
Mailing Address - Country:US
Mailing Address - Phone:317-626-5309
Mailing Address - Fax:
Practice Address - Street 1:2345 S LYNHURST DR STE 205
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-5100
Practice Address - Country:US
Practice Address - Phone:317-272-1713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006506A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical