Provider Demographics
NPI:1770701021
Name:STEVENS, LUCY (MA)
Entity type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12511 SE 304TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-2107
Mailing Address - Country:US
Mailing Address - Phone:253-931-0105
Mailing Address - Fax:
Practice Address - Street 1:220 S 3RD PL
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-2405
Practice Address - Country:US
Practice Address - Phone:425-228-0074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00047781101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor