Provider Demographics
NPI:1356624167
Name:STEVENS, LISA M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:M
Last Name:STEVENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:M
Other - Last Name:BELLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:970 ROUTE 146
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3643
Mailing Address - Country:US
Mailing Address - Phone:518-881-0446
Mailing Address - Fax:518-383-1490
Practice Address - Street 1:970 ROUTE 146
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3643
Practice Address - Country:US
Practice Address - Phone:518-881-0446
Practice Address - Fax:518-383-1490
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0774701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical