Provider Demographics
NPI:1841452786
Name:STEVENSON, KEVIN MICHAEL (LMHC, CAP)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:MICHAEL
Last Name:STEVENSON
Suffix:
Gender:M
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6611 US HIGHWAY 19
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-1732
Mailing Address - Country:US
Mailing Address - Phone:727-741-0704
Mailing Address - Fax:888-972-7961
Practice Address - Street 1:6611 US HIGHWAY 19
Practice Address - Street 2:SUITE 203
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1732
Practice Address - Country:US
Practice Address - Phone:727-741-0704
Practice Address - Fax:888-972-7961
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 7098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health