Provider Demographics
NPI:1003123613
Name:STEPHEN & ASSOCIATES, LLC
Entity type:Organization
Organization Name:STEPHEN & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE & FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:219-613-2122
Mailing Address - Street 1:7863 BROADWAY STE 115
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5564
Mailing Address - Country:US
Mailing Address - Phone:219-613-9050
Mailing Address - Fax:219-794-1226
Practice Address - Street 1:7863 BROADWAY STE 115
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5564
Practice Address - Country:US
Practice Address - Phone:219-613-9050
Practice Address - Fax:219-794-1226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health