Provider Demographics
NPI:1992832414
Name:STEVENS, CHERYL ANN (MD, UNLICENSED)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MD, UNLICENSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3327
Mailing Address - Country:US
Mailing Address - Phone:413-209-3124
Mailing Address - Fax:413-209-3127
Practice Address - Street 1:117 PARK AVE
Practice Address - Street 2:200
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3327
Practice Address - Country:US
Practice Address - Phone:413-209-3124
Practice Address - Fax:413-209-3127
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)