Provider Demographics
NPI:1336917996
Name:STEVENS, DEREK LEE (LPC-C)
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:LEE
Last Name:STEVENS
Suffix:
Gender:M
Credentials:LPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E HADDOCK ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-8716
Mailing Address - Country:US
Mailing Address - Phone:405-443-7619
Mailing Address - Fax:
Practice Address - Street 1:1008 24TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6369
Practice Address - Country:US
Practice Address - Phone:405-310-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health